EDITORIAL

e are very pleased to bring you the second edition of Communities, Children and Families Australia. When Professor Dorothy Sco launched the journal in July 2006 she did so hopeful that it would be able to carry out its aims and that it would endure. The editorial commiee recently reected on our hopes that the journal may be a useful forum for challenging the orthodoxy of current ways of thinking in child protection. To do this we felt it is essential that it crosses the dierent arenas in which we work: practice, policy, research, education and management, as well as the dierent disciplines and sectors which all contribute to the wellbeing and safety of children and young people. Challenging the conventional gaps between primary, secondary and tertiary interventions (currently embedded in Commonwealth and States/Territories responsibilities and funding arrangements), the journal will feature articles which recognise the strong interface needed between early intervention, targeted approaches and statutory child protection. Some of these themes are reected in this edition. Two articles (Connelly & Doolan; Bromeld & Ryan) are the collaborations of practitioners and researchers. Three (Connelly & Doolan; Wyles; Richmond) reect on the implications of specic child death reviews; articles (McHugh; Harries, Lonne & Thomson; Blakester) challenge conventional orthodoxies such as ethics in child protection, the cost of fostering, and the frames through which we view child abuse and neglect; two writers, (Daro; Richmond), both with extensive experience working across the early intervention and statutory child protection spectrum, explore the potential of particular early intervention strategies to prevent harm to children.

One of the positive spin os from aending various conferences last year, including the XVIth ISPCAN International Congress on Child Abuse and Neglect in York was that four high prole international gures accepted invitations to our editorial board. They are: Professor Ken Barter, Memorial University, Canada; Deborah Daro, Research Fellow, Chapin Hall at the University of Chicago; Nigel Parton, Professor in Child Care and Director of the Centre for Applied Childhood Studies, University of Hudderseld and Pamela Tevithick who holds the eld chair in social work at the University of Bristol. At our invitation, Deborah Daro provides an in depth analysis of research on early home visitation programs which she places within the broader context of early intervention systems generally. In Deborahs view the prenatal care and wellbeing visits provided universally as part of primary health care throughout Australia provides a promising platform on which to build a network of more intensive early intervention eorts. Although acknowledging that home visitation is not a singular solution for preventing child abuse, Deborah claims that the empirical evidence generated so far does support the growing capacity of quality programs to achieve their aims. Deborahs conclusions about the importance of solid internal consistency within programs that link specic program elements to specic outcomes is of great signicance in the broader Australian human services context with the outsourcing of many services and the challenge to identify meaningful performance measures which drive rather than impede good practice. The promising platform of maternal and child
1

Editorial

health services in Australia referred to by Daro is explored further in Giovanna Richmonds article on policy partnerships between health and child protection systems. Despite the extensive range of primary and targeted health services which reach a very large proportion of the population, especially in the rst three years, Giovanna presents the view that the health sectors response to child abuse and neglect at the primary and secondary levels of prevention needs to be broader in scope and directed by specic cross sectoral policy. The unintended consequence of mandatory reporting, she claims, is an abrogation of responsibility on the part of health workers to statutory workers and isolation for many health professionals who nd themselves navigating the child protection system instead of being an integral part of it. A policy partnership forged between health and child protection resulted in the development of a comprehensive training strategy for all health professionals (developed by health professionals), creation of inter sectoral liaison positions, and enhanced interdisciplinary integration such as the introduction of nursing positions into key tertiary institutions. Finally Giovanna provides a conceptual framework for improving integration which includes three key elements: explicit cross sectoral policy; the identication of benets and barriers; and the eective management of boundaries between health and child protection domains through dedicated leadership. In past decades child death and other high prole inquiries and the media responses to them, have played a paramount role in changes to child welfare practice which has been dominated by conservative, risk averse procedures. As Marie Connolly and Mike Doolan argue, reviewing child deaths can create a culture of blame and precipitate reactive responses that do lile to promote practice improvements. Marie Connolly, Chief Social Worker within the New Zealand Government and Mike Doolan, Adjunct Senior Fellow at the University of Canterbury discuss the practice issues raised by an in depth analysis of nine homicides of children known to statutory child protection services in New Zealand over a four year period. They argue there is a harsh reality that not all violence towards children can be predicted, nor does this mean that all families who

struggle to care for their children should be treated as potential child killers. Instead ne practice judgements which balance short and long term risks to children including the risks involved in placing children in the care system, must be made at every point. Marie and Mikes article also reminds us how important this kind of analysis is because it can help in times of high political and media pressure to explain the complexity of decision making in child protection. If child protection environments allow in depth reviews of such cases, important practice insights and improved procedures can result. Some of the issues raised by Marie and Mike reect the dicult ethical dilemmas facing child protection workers every moment of every day. The paper by Maria Harries, (University of Western Australia), Bob Lonne (University of Queensland) and Jane Thomson, (James Cook University), is a fascinating and timely discussion of the ethical foundations of Child Welfare. Arguing that much of contemporary practice is fundamentally awed by its preoccupation with managing immediate risks and risk avoidance (justied by the highly seductive rhetoric of the best interests principle) they claim that decisions oen fail to take into account long term impacts on the wellbeing of children and their location within families and communities. This aention to short term risk also overlooks the wider context of structural disadvantage aecting most families involved with the child protection system. The authors put forward a theoretical framework comprising three conceptual elements which they argue form the crux of good ethical decision making. These are: competing ethical principles; power; and complex stakeholder relationships. This rich discussion argues for a greater understanding of the context of power relations in Child Protection. It also challenges people working in the system to develop a strong value base in which a duty to protect children is balanced with the principle of respect for all people involved and where the principle of justice is permied to nd a place back at the decision making table. Continuing with themes emerging from child death and other inquiries Paul Wyles, a Director in the ACT Oce of Child, Youth and Family Support, explores three recent Australian child protection reviews

to analyse their aention to the role professional supervision can play in improving outcomes. He nds that they oer lile direction, telling us what we already know and understand. There is lile focus on the central role professional supervision can play in building beer child protection systems in this country. Instead supervision referred to in reviews tends to be narrowly dened as line supervision and is almost solely about performance management and monitoring. Paul argues from experience that administrative supervision does not capture the inherent complexities of work in human service organisations. The danger, he claims, with inevitable future reviews is that supervision will increasingly be seen as a tool for compliance rather than for fullling broader purposes such as assisting sta to think through the ethical considerations outlined in the previous article. Paul concludes with some recommendations about a range of strategies that sit comfortably between managerial and professional paradigms. The importance of targeted recruitment, timely induction, entry level training and ongoing support and supervision for child protection practitioners is reiterated in the article by Leah Bromeld and Robert Ryan. Reecting the academic and practice partnerships that the journal seeks to encourage, Leah, from the National Child Protection Clearinghouse, and Robert, from the Queensland Department of Child Safety, collaborate to provide a national comparison of child protection training in Australian. The ndings from this snapshot (October 2005March 2006), undertaken to enhance the goals of the Australasian Statutory Child Protection Learning and Development Group, are useful for policy makers, trainers, practitioners and researchers. In particular the paper increases the awareness of the knowledge and skills expected of statutory child protection workers. Of signicance, only half of the jurisdictions had formal assessment processes in place to determine whether trainees had acquired requisite skills and only two jurisdictions formally evaluated their training programs. The authors identify assessment and evaluation as priority areas for future research. In her paper about the costs of fostering Marilyn McHugh asks the question Is it time

for consideration of a carer payment? Marilyn provides a detailed analysis of reasons for a crisis in foster care in Australia including the social and economic factors contributing to a reduction of the availability of women as volunteers, the increasing complexity of childrens behaviour in care and growing expectations on carers to perform additional tasks. Interviews with thirty foster carers indicated that carers incur psychological and emotional costs through the maintenance of a complex range of relationships; opportunity costs through loss of employment and superannuation; and time costs involved in the additional fostering tasks over and above normal non foster care specic activities. The paper examines international developments, particularly in the UK, France and Sweden, which point to nancial support for carers far in advance of what is provided in Australian child welfare systems. The dierences range from tax relief, payments for child expenses plus wages which are guaranteed for temporary absences of children and for three months aer children ceased being placed with the carer. In Sweden, if a carer is required to stay at home due to the childs special needs, the wage component is doubled as compensation for lost employment income. Finally, we are pleased to publish Adam Blakester, the National Executive Ocer of NAPCAN ,s reective piece on NAPCANs shi to a communitywide and community responsibility focus. Adam claims that the phrase prevent child abuse and neglect conjures up in the public mind a need for professional intervention rather than community responsibility. He explains in depth the reasons why the new NAPCAN will reframe its work to encourage sustainable, child friendly communities that provide and support childrens wellbeing. Adams background in commerce and law leads him to explore the economic costs of child abuse and neglect, which, he points out, at an estimated $5billion in 2003 was more than Australias annual income from meat exports. Drawing on the parallel between the massive human and nancial investment needed to combat the long term impacts of climate change and the approach to child abuse and neglect, where only one third of one percent of current expenditure is invested in prevention, Adam provides staggering

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Editorial

ARTICLE
evidence of the lack of a national approach to the laer. He contrasts the 1.2 billion dollars spent by state governments on the tertiary response to child abuse and neglect in 2004-2005 with the Australian governments contribution of 4.2 million dollars to prevention, one three hundredth of this amount, in the same period. We hope this edition is of interest to readers. Once again we thank those who have worked hard to produce it. Our special thanks go to the growing College for Child and Family Protection Practitioners for their very generous support and encouragement. Gail Winkworth Editor

Perspectives on Early Childhood Home Visitation Programs: Improving Quality and Enhancing Outcomes
Deborah Daro PhD
ABSTRACT
The rapid expansion of home visitation services over the past two decades has sparked lively debate over the methods ecacy and structural integrity in both the United States and Australia. Many reviewers nd the current evidence base sucient to justify continued program expansion while others nd the evidentiary base inconclusive, particularly in the area of preventing child abuse. Evaluators and reviewers that note limited or disappointing impacts oen call for greater aention to issues of program quality and more modest expectations as to what can be accomplished through any single intervention. The purpose of this article is to place these concerns within the broader context of craing early intervention systems, to identify the improvements in model clarity and outcomes being documented within the expanding body of empirical research, and to outline the key questions facing policy makers and program managers seeking to build a more comprehensive and relevant pool of empirical ndings to guide practice.

OVERVIEW
Early intervention eorts to promote healthy child development have long been a central feature of social service and public health reforms. Central to this strategy has been an explicit recognition of the importance of the rst three years of life in shaping cognitive and socio-emotional development. In Australia, pre-natal care, well-baby visits and assessments to detect possible developmental delays are provided on a universal basis through a publicly supported system of nurse visits and centre-based primary health care (Sco, 2006). Although the accessibility and quality in these services varies among the states, this system provides a promising platform on which to build a network of more intensive early interventions eorts. In the United States, eorts to provide support for new borns and their parents has developed without the benet of a publicly funded health care system or the type of universal health home visiting found in Australia and many other western democracies. Although a plethora of options exists for providing assistance to parents around the time their child is born,

Deborah Daro Research Fellow (Associate Professor) Chapin Hall Centre for Children University of Chicago 1313 E. 60th Street Chicago, IL 60637 USA Phone: +1 773-256-5127 Fax: +1 773-753-5940 E-mail: ddaro@uchicago.edu 4 Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 1

home visitation has become the agship program in the United States for reaching out to new parents. Child abuse prevention advocates, in particular, have aggressively promoted this strategy for over two decades. They are guided by the belief that the strategy can reduce the risk for maltreatment by strengthening early parent-child relationships and linking new parents with needed health care and social services (Daro & Cohn-Donnelly, 2002). Within this paradigm, home visitation programs serve both as an intervention with its own mission and service portfolio as well as a gatekeeper to other community resources. These other resources include not only the health services common in public health nurse visiting programs but also the therapeutic and concrete services necessary to insure a parents ability to provide a safe and nurturing environment for her child. Some of the models extend their outreach to all new parents or pregnant women; some target populations presenting specic risk characteristics such as young maternal age, single parent status or low income; and others embed more intensive, targeted services for those parents facing specic challenges within a universal system of initial assessment and referral (Daro, 2000). In addition to a number of national models available in the U.S. (e.g., Parents as Teachers, Healthy Families America, Early Head Start, Parent Child Home Program, HIPPY, and the Nurse Family Partnership), 37 of the 50 states have early intervention systems that include some form of home visitation services (Johnson, 2001). Rapid expansion of home visitation programs also is occurring throughout Australia at both the federal and state levels (Vimpani, 2000; Holzer, Higgins, Bromeld & Higgins, 2006; Horin, 2005). In New South Wales, for example, the Department of Community Services estimated the need for more than $261 million in new funding between Financial Year 2003 and Financial Year 2007 to develop an early intervention service system capable of reducing referrals to child protective services (NSW Department of Community Services, 2003). Although a variety of strategies will be used to accomplish this objective, universal and targeted home visitation programs play a central role in these systems. Indeed, a 1996 national audit of child
6

abuse prevention programs in Australia found that one quarter of these programs included a home visitation component (Vimpani, Frederico, Barclay & Davis, 1996). The rapid expansion of home visitation services has sparked increased scrutiny of the strategys empirical evidence and lively debate over the methods ecacy and structural integrity in the United States (Chan, 2004; Gomby, 2005; Hahn, Bilukha, Crosby, Fullilove, Liberman, Moscicki, Snyder, Tuma, Schoeld, Corso & Briss, 2003; Karoly, Kilburn & Cannon, 2005) as well as Australia (Higgins, Bromeld & Richardson, 2006; Holzer, Higgins, Bromeld and Higgins, 2006). Evaluators and reviewers that note limited or disappointing impacts oen call for greater aention to issues of quality and more modest expectations as to what can be accomplished through any single intervention (Chan, 2004;Vimpani, 2002). These assumptions mixed outcomes, uneven quality and overstating what one can accomplish are valid concerns particularly when an intervention commands a greater proportion of public and private resources. Determining if sucient aention is being paid to these issues, however, requires a nuanced assessment of the data, one that places specic ndings within an historical context. The purpose of this article is to place these concerns within the broader context of craing early intervention systems, to identify the improvements in model clarity and outcomes being documented within the expanding body of empirical research, and to outline the key questions facing policy makers and program managers seeking to build a more comprehensive and relevant pool of empirical ndings to guide practice. 773/753-5940

the parent-child relationship (Shonko & Phillips 2000). The empirical base for this conclusion grew out of the early brain research, translated for popular consumption by the Carnegie Foundations Starting Points report (1994) and a plethora of media stories. Longitudinal studies on early intervention eorts implemented in the 1960s and 1970s found marked improvements in educational outcomes and adult earnings among children exposed to highquality early intervention programs (Campbell, Ramey, Pungello, Sparling & Miller-Johnson, 2002; McCormick, Brooks-Gunn, Buka, Goldman, Yu, Salganik, Sco, Benne, Kay, Bernbaum, Bauer, Martin, Woods, Martin & Casey, 2006; Reynolds, Temple, Robertson & Mann, 2001; Schweinhart, 2004; Seitz, Rosenbaum & Apfel, 1985). These data also conrmed what child abuse prevention advocates had long believedgeing parents o to a good start in their relationship with their infant is important for both the infants development and for their relationship with parents and caretakers (Cohn, 1983; Elmer, 1977; Kempe, 1976). The key policy message from this body of research is that learning begins at birth and that maximizing a childs developmental potential requires more comprehensive methods to reach new borns and their parents. Individuals may debate how best to reach young children; few dispute the fact that such outreach is essential for insuring a childs healthy development.

among rst-time, low-income teenage mothers was oen cited as evidence the method worked, the fact that at least a dozen assessments of other home visitation eorts had demonstrated gains in such diverse outcomes as parent-child aachment, improved access to preventive medical care, parental capacity and functioning, and early identication of developmental delays was equally inuential (Daro, 1993). This paern of ndings, coupled with the growing acceptance of initiating services at the time a child is born, provided a compelling empirical and political base for the initial promotion of more extensive and coordinated home visitation services in the United States as well as in Australia.

THE EVIDENCE OF SUCCESS

Over the past 15 years, numerous researchers have examined the eects of home visitation programs on parent-child relationships, maternal functioning and child development. These evaluations also have addressed such important issues as costs, program intensity, sta requirements, training and supervision, and the variation in design necessary to meet the dierential needs of a diverse new-parent population. Some of these studies have conrmed the initial faith placed in the strategy; others nd that many questions remain unanswered, even as nations continue to expand services in this area. Aempts to summarize this research have drawn dierent conclusions. In some cases, the authors conclude that the strategy, when well implemented, does produce signicant and meaningful reduction in child-abuse risk and improves child and family functioning (AAP Council on Child and Adolescent Health, 1998; Geeraert, Van den Noorgate, Grietens & Onghena, 2004; Guterman, 2001; Hahn, et al., 2003). Other reviews draw a more sobering conclusion (Chan, 2004; Gomby, 2005; Holzer, Higgins, Bromeld, Higgins, 2006). In some instances, these disparate conclusions reect dierent expectations regarding what constitutes meaningful change; in other cases, the dierence stems from examining dierent studies or placing greater emphasis on certain methodological approaches (e.g., randomized controlled studies). It should not be surprising to nd more promising
7

WHY HOME VISITATION?

The current generation of home visitation programs drew on the experiences of western democracies with a long history of providing universal home visitation systems to assess and support every new born (Krugman, 1993). This policy context, coupled with the initial promising results of David Olds nurse home visitation program in Elmira, New York (Olds, Henderson, Chamberlin & Tatelbaum, 1986), led the U.S. Advisory Board on Child Abuse and Neglect to conclude that no other single intervention has the promise of home visitation (U.S. Advisory Board, 1991: 145). Although the Olds data showing initial reductions in reported rates of child abuse

THE BROADER CONTEXT OF EARLY LEARNING

Before considering the specic outcomes of home visitation programs, it is important to reect on the full body of research that initially supported an emphasis on newborns and their parents. Over the past 20 years, a broad body of research has emerged which highlights the rst 3 years of life as a particularly important intervention period for inuencing a childs trajectory and the nature of

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 1

outcomes over time. The database used to assess program eects is continually expanding, with a greater proportion of these evaluations capturing post-termination assessments of models that are beer specied and beer implemented. In their examination of 60 home visiting programs, Sweet and Appelbaum (2004) documented a signicant reduction in potential abuse and neglect as measured by emergency room visits and treated injuries, ingestions or accidents (ES = .239, p < .001). The eect of home visitation on reported or suspected maltreatment was moderate but insignicant (ES = .318, ns), though failure to nd signicance may be due to the limited number of eects sizes available for analysis of this outcome (k = 7). Geeraert, et al. (2004) focused their meta-analysis on 43 programs with an explicit focus on preventing child abuse and neglect for families with children under 3 years of age. Though programs varied in service delivery strategy, 88 percent (n = 38) incorporated a home visitation component. This meta-analysis, which included 18 post-2000 evaluations not included in the Sweet and Appelbaum summary, notes a signicant, positive overall treatment eect on child abuse reports, and on injury data (ES = .26, p < .001), somewhat larger than the eect sizes documented by Sweet and Appelbaum. Stronger impacts over time also are noted in the eects of home visitation on other child and family functioning. Although they did not nd compelling evidence with respect to reducing child abuse reports, Bull and her colleagues concluded that home visiting can produce positive eects on various dimensions of parenting and mother-child interactions (Bull, McCormick, Swann, & Mulvihill, 2004). Sweet and Appelbaum (2004) note that home visitation produced signicant but relatively small eects on the mothers behaviour, aitudes, and educational aainment (ES < .18). In contrast, Geeraert et al. (2004) nd stronger eects on indicators of child and parent functioning, ranging from .23 to .38. Similar paerns are emerging from recent evaluations conducted on the types of home visitation models frequently included within public service systems for children aged 0 to 5. Such evaluations are not only more plentiful, but also are increasingly sophisticated,
8

utilizing larger samples, more rigorous designs, and stronger measures. Some of these eorts incorporate an array of qualitative techniques, making it dicult to capture their ndings in standard meta-analytic reviews. In some cases, the omissions of these evaluations is not a result of methodology but rather the fact that ndings are not always published in peer reviewed journals, and therefore not easily accessible to those relying on traditional journal search methods to identify relevant studies. Although positive outcomes continue to be far from universal, parents enrolled in these home visitation programs report fewer acts of abuse or neglect toward their children over time (Fergusson, et al., 2005; LeCroy & Milligan, 2005; Mitchel-Herzfeld, Izzo, Green, Lee & Lowenfels, 2005; William, Stern & Associates, 2005); more positive health outcomes for the infant and mother (Fergusson, Grant, Horwood & Ridder, 2005); more positive and satisfying interactions with their infants (Klagholz, 2005); and a greater number of life choices that create more stable and nurturing environments for their children than either participants in a formal control group or than various comparison groups identied on the basis of similar demographic characteristics and service levels (Anisfeld, Sandy & Guterman, 2004; LeCroy & Milligan, 2005; Wagner, & Spiker, 2001). One home visitation model that initiates services during pregnancy has found that its teenage participants reported signicantly fewer negative outcomes by age 15 (e.g., running away, juvenile oences and substance abuse) (Olds, Eckenrode, Henderson, Cole, Kitzman, Luckey, Pei, Sidora, Morris & Powers, 1998). A randomized trial of a Brisbane nursing home visitation program paerned on the work of Olds found signicant reductions in postnatal maternal depression and improved maternal-infant aachment at six-weeks post-partum (Armstrong, Fraser, Dadds & Morris, 1999) and enhanced parental ecacy and greater acceptance of the child at 4 months post-partum (Armstrong, Fraser, Dadds & Morris, 2000). Home visits oered later in a childs development also have produced positive outcomes. Toddlers who have participated in home visitation programs specically designed to prepare them for school are entering kindergarten demonstrating at least three

factors correlated with later academic successsocial competency, parental involvement, and early literacy skills (Levenstein, Levenstein & Oliver, 2002; Allen & Sethi, 2003; Pfannenstiel, Seitz & Zigler, 2002). Longitudinal studies of home visitation services initiating services at this developmental stage have found positive eects on school performance and behaviours through sixth grade (Bradley & Gilkey, 2002) as well as lower high school dropout and higher graduation rates (Levenstein, Levenstein, Shiminski & Stolzberg, 1998). In addition to documenting the positive impacts of home visitation services, these studies are contributing to a broader understanding of how to do this work beer. When mothers are enrolled during pregnancy, not only are birth outcomes more positive but mothers enrolled during this period have stronger parenting outcomes than women enrolled post-natally (Mitchel-Herzfeld, et al., 2005). Although positive impacts have been observed by programs employing home visitors with various educational backgrounds and skills, one study, which examined the relative merits of dierent types of home visitors within the context of a program designed to be provided by nurses, found nurses more eective in achieving program goals than a group of paraprofessionals (Olds, Robinson, OBrien, Luckey, Pei, Henderson, Ng, She, Korfmacher, Hia & Talmi, 2002). In contrast, a randomized trial of a home visitation program focusing on health promotion and provided by experienced mothers from a high risk community found higher immunization rates and more positive parent-child interactions among the intervention group in contrast to a group of women who only received the communitys standard health visits provided by nurses (Johnson, Howell & Molloy, 1993). Independent of provider characteristics, outcomes can be enhanced when home visitation is partnered with other early intervention services or specialised support (Anisfeld, Sandy & Guterman, 2004; Daro & McCurdy, 2006; Klagholz, 2005; Love, Kisker, Ross, Schochet, Brooks-Gunn, Paulsell, Boller, Constantine, Voget, Fuligni & Brady-Smith, 2002). Despite continued variation in program objectives and approach, agreement is growing around a

number of key factors that represent the types of programs most likely to accomplish expectations. This list includes: solid internal consistency that links specic program elements to specic outcomes; forming an established relationship with a family that extends for a sucient period of time to accomplish meaningful change in a parents knowledge levels, skills and ability to form a strong positive aachment to her infant; well-trained and competent sta; high-quality supervision that includes observation of the provider and participant; solid organisational capacity in the communitybased organizations frequently recruited to coordinate and deliver these programs; and linkages to other community resources and supports.

ASSURING CONTINUOUS PROGRAM IMPROVEMENT

Greater positive impacts among a broad range of home visitation models reect, in part, two trends improved program quality and improved conceptual clarity. With respect to quality, most of the major national home visitation models in the U.S. are engaged in a series of self-evaluation eorts designed to beer articulate those factors associated with stronger impacts and to beer monitor their replication eorts. For example the Nurse Family Partnerships (NFP) maintains rigorous standards with respect to program site selection. Data collected by nurse home visitors at local sites is reported through the NFPs web-based Clinical Information System (CIS), and the NFP national oce manages the CIS and provides technical support for data entry and report delivery. These data provide information to sites about program management, details on how closely a site is following the program model, and compare individual sites with other NFP sites to help nurse home visitors rene their practice. Since 1997, Healthy Families Americas (HFA) credentialing system has monitored program adherence to a set of research-based critical elements covering various service delivery aspects, program

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 1

content, and stang. In an eort to promote ongoing quality improvement, the standards have been revised periodically to meet the changing needs of families and programs. At present, over 80 sites use a common data collection system developed by the national sta to monitor implementation and ensure compliance with these standards. In addition, an implementation study conducted in 2004 brought researchers and practitioners together to examine key challenges within the service delivery process, including issues of participant and sta retention, service intensity, sta supervision, and service content. And, aer 3 years of extensive pilot testing and review, Parents as Teachers (PAT) released its Standards and Self-Assessment Guide in 2004. Every 3 years, PAT programs are expected to complete a self-assessment process that covers service delivery and program management indicators, which emphasise continuous quality improvement. In addition to model-specic eorts, representatives from six national models (NFP, HFA, PAT, Parent Child Home Program, HIPPY, and Early Head Start) have worked collaboratively as part of a Home Visit Forum since December 1999 to explore possible areas of mutual need and interest and to establish a vehicle for cross-program cooperation (Weiss, 2004). At the time it was established, the Forum commied to achieving three major goals, considered central to advancing research and service provision in the eld of home visiting: strengthening the empirical and clinical capacity to assess and improve home visit services and outcomes; developing strategic multi-model research inquiries and reinforcing the reciprocal links back to practice, training, and model development; and creating and supporting eorts to share and explore the implications of lessons learned with the broader home visitation eld. Over time, this process has resulted in the renement of each models theory of change, in the development of shared standards with respect to sta training and supervision, and in the commitment to advocate

for program expansion within a framework of best practice standards supported by empirical evidence.

ACHIEVING BROADER OUTCOMES

Home visitation is not the singular solution for preventing child abuse, improving a childs developmental trajectory or establishing a strong and nurturing parent child relationship. As several authors have noted, it may be a necessary but certainly insucient strategy for improving child well-being (Vimpani, 2000; Weiss, 1993). However, the empirical evidence generated so far does support the ecacy of the model and its growing capacity to achieve its stated objectives with an increasing proportion of new parents. Maintaining this upward trend will require continued vigilance to the issues of quality, including sta training, supervision, and content development (Heaman, Chalmers, Woodgate & Brown, 2006). It also requires that home visitation be augmented by other interventions that provide deeper, more focused support for young children and foster the type of contextual change necessary to provide parents adequate support (Daro, 1993; Vimpani, 2000). These additions are particularly important in assisting families facing signicant challenges as a result of extreme poverty, domestic violence, substance abuse or mental health concerns. Creating a knowledge base capable of supporting programmatic expansion requires a broad scope of inquiry and a set of diverse research methodologies. Home visitation eorts, as with all social interventions, are well served when they embrace the evaluation process and engage in continuous program improvement. As noted in this review, a growing number of randomisd trials assessing home visitation programs are surfacing in the literature, providing increased evidence of the strategys ecacy home visitation programs when well craed and carefully implemented produce positive outcomes for children and their parents. Maximisng the utility of program evaluation eorts, however, requires more than just randomisd clinical trials. A central challenge facing home visitation programs is expanding service availability without

sacricing quality. With respect to program quality, program evaluators in both the U.S. and Australia are currently engaged in a myriad of studies to address key implementation questions how do families view the home visits they are being oered, why do they accept or not accept oers to enrol in these programs, what other support options do new parents want to see within their community, and how do new parents view their relationship with the home visitors:? The issue of program delity, central to randomized clinical trials, takes on new meaning when one goal of the intervention is to be responsive to a familys needs and a communitys strengths. Even within the context of a well specied curriculum or service protocol, each home visit represents a unique exchange between provider and participant, an exchange that is shaped by a familys immediate needs and a home visitors service delivery style. By assuming families who received a similar number of home visits or who remain enrolled for a similar length of time have had the same service experience, randomized trials can easily overstate or understate an interventions potential and, more importantly, fail to document key variations in service delivery that might account for dierential impacts. Using only randomized clinical trials to assess home visitation programs reduces the ability of program evaluations to generate the types of ndings central to achieving continuous program improvement.

appropriate scope for these eorts and their ultimate impacts. Within the rational current of policy and program development, however, evaluators oer a unique set of skills. Properly constructed and implemented policy and program evaluations can go a long way toward clarifying objectives, determining impacts, and dening the paradigms of broadly dened family support and child enhancement eorts. Although many of the questions surrounding the ultimate expansion of early intervention services will reect deeply held values of family privacy, child protection and parental rights, evaluative results can be used to ensure that those programs which are funded reect the most current and reliable ndings regarding program ecacy.

REFERENCES
Allen, L. & Sethi, A. (2003) An evaluation of graduates of the Parent-Child Home Program at Kindergarten Age. The Child and Family Policy Centre: New York University. American Academy of Pediatrics, Council on Child and Adolescent Health. (1998) The role of homevisitation programs in improving health outcomes for children and families. Pediatrics, 10(3), 486-489. Anisfeld, E., Sandy, J. & Guterman, N. (2004) Best Beginnings: A Randomized Controlled Trial of a Paraprofessional Home Visiting Program. Final Report submied to the Smith Richardson Foundation and New York State Oce of Children and Family Services. December. hp://www. healthyfamiliesamerica.org/research/index.shtml Armstrong, K., Fraser, J., Dadds, M., & Morris, J. (1999) A randomized controlled trial of nurse home visiting to vulnerable families with newborns. Journal of Pediatric Child Health, 35, 237-244. Armstrong, K., Fraser, J., Dadds, M., & Morris, J. (2000) Promoting secure aachment, maternal mood and child health in a vulnerable population: A randomized controlled trial. Journal of Pediatric Child Health, 36, 555-562.

CONCLUSION
No system of universal support for new parents, regardless of scope or quality, will solve all of societys social ills. Some children will still experience injury or limited social and cognitive development because their parents are unable or unwilling to care for them. Some parents will still fail to secure needed services for their children because local service options will remain inaccessible or non-existent. Some communities will still be too violent to allow children to play outside their homes because prevention eorts have failed to challenge an economic system which locks so many in a continuing cycle of poverty and dependency. In a sense, the more we learn about planning and implementing prevention services, the more we realise how lile we know about the

10

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 1

11

Bradley, R. & Gilkey, B. (2002) The impacts of the Home Instructional Program for Preschool Youngsters (HIPPY) on school performance in 3rd and 6th grade. Early Education and Development, 13(3), 302-311. Bull, J., McCormick, G., Swann, C., & Mulvihill, C. (2004) Ante- and post-natal home visiting programs: A review of reviews. Evidence Brieng, First Edition (February). Available at UK Health Development Agency www.hda.nhs.uk/evidence Campbell, F. A., Ramey, C. T., Pungello, E. P., Sparling, J., & Miller-Johnson, S. (2002) Early Childhood Education: Young Adult Outcomes from the Abecedarian Project. Applied Developmental Science, 6, 42-57. Carnegie Task Force on Meeting the Needs of Young Children (1994) Starting Points: Meeting the needs of our youngest children. Carnegie Corporation of New York, New York. Chan, M. (2004) Is it time to rethink Healthy Start/ Healthy Families? Child Abuse and Neglect, 28, 589595. Cohn, A. (1983) An Approach to Preventing Child Abuse. Chicago, IL: National Commiee to Prevent Child Abuse. Daro, D. (1993) Child maltreatment research: Implications for program design. In Cicchei, D. & Toth, S. (eds.). Child Abuse, Child Development, and Social Policy. Norwood, NJ: Ablex Publishing Corporation, 331-367. Daro, D. (2000) Child abuse prevention: New directions and challenges. Journal on Motivation, 46, Nebraska Symposium on Motivation. Lincoln, NB: University of Nebraska Press, 161-219. Daro, D. & Cohn-Donnelly, A. (2002). Charting the waves of prevention: Two steps forward, one step back. Child Abuse and Neglect, 26, 731-742. Daro, D. & McCurdy, K. (2006) Interventions to prevent child maltreatment. In Doll, L., Mercy, J., Hammond, R., Sleet, D., & Bonzo, S. (eds). Handbook on Injury and Violence Prevention Interventions. New York: Kluwer Academic/Plenum Publishers.

Early Head Start National Resource Centre. National oce web site: www.ehsnrc.org Elmer, E. (1977) Fragile Families, Troubled Children: The Aermath of Infant Trauma. Pisburgh, PA: University of Pisburgh Press. Fergusson, D., Grant, H., Horwood, & Ridder, E., (2005) Randomized trial of the Early Start Program of home visitation. Pediatrics, 11(6), 803-809. Geeraert, L., Van den Noorgate, W., Grietens, H., and Onghena, P. (2004) The eects of early prevention programs for families with young children at risk for physical child abuse and neglect: A metaanalysis. Child Maltreatment, 9(3), 277-291. Gomby, D. (2005) Home Visitation in 2005: Outcomes for Children and Parents. Invest in Kids Working Paper No. 7. Commiee for Economic Development: Invest in Kids Working Group. July. Available at www.ced.org/projects/kids.shtml Guterman, N. (2001) Stopping Child Maltreatment Before It Starts: Emerging Horizons in Early Home Visitation Services. Sage, Thousand Oaks. Hahn, R., Bilukha, O., Crosby, A., Fullilove, M., Liberman, A., Moscicki, E., Snyder, S., Tuma, F., Schoeld, A., Corso, P., & Briss, P. (2003) First reports evaluating the eectiveness of strategies for preventing violence: Early childhood home visitation. Findings from the Task Force on Community Prevention Services. Morbidity and Mortality Weekly Report, 52(RR-14), 1-9. Heaman, M., Chalmers, K., Woodgate, R., & Brown, J. (2006) Early childhood home visiting program: Factors contributing to success. Journal of Advanced Nursing, 55(3), 291-300. Healthy Families America (HFA). National oce web site: www.healthyfamiliesamerica.org Higgins, D., Bromeld, L., & Richardson, N. (2006) The eectiveness of home visiting program for preventing child maltreatment. National Child Protection Clearinghouse Research Brief, Number 2. Home Instruction for Parents of Preschool Youngsters (HIPPY). National oce web site: www.hippyusa. org

Holzer, P., Higgins, J., Bromeld, L., & Higgins, D. (2006) The eectiveness of parent education and home visiting child maltreatment prevention programs. Child Abuse Prevention Issues, 24 (Autumn). Horin, A. (2005) Millions for programs, but results are sparse. The Sydney Morning Herald, March 14. Johnson, K. (2001) No Place Like Home: State Home Visiting Policies and Programs. Report prepared for the Commonwealth Fund. Available at www. cmwf.org. Johnson, Z., Howell, F., Molloy, B. (1993) Community mothers program: Randomized controlled trial of non-professional intervention in parenting. British Medical Journal, 306 (6890), 1449-1452. Karoly, L., Kilburn, M.R., & Cannon, J. (2005) Early Childhood Interventions: Proven Results, Future Promise. Report prepared for the PNC Financial Services Group. Santa Monica, CA: Rand Corporation. Kempe, H. (1976) Approaches to preventing child abuse: the health visitor concept. American Journal of Diseases of Children, 130, 940-947. Klagholz, D. (2005) Starting Early Starting Smart: Final Report. Great Falls, VA: Donna D. Klagholz & Associates, LLC. hp://www. healthyfamiliesamerica.org/research/index.shtml Krugman, R. (1993) Universal home visiting: A recommendation from the U.S. Advisory Board on Child Abuse and Neglect. The Future of Children, 3(3), 184-191. LeCroy & Milligan Associates, Inc. (2005) Healthy Families Arizona Evaluation Report 2005. Tucson, AZ: Author. hp://www.healthyfamiliesamerica. org/research/index.shtml Levenstein, P., Levenstein, S. & Oliver, D. (2002). First grade school readiness of former child participants in a South Carolina replication of Parent-Child Home Program. Journal of Applied Developmental Psychology, 23, 331-353.

Levenstein, P., Levenstein, S., Shiminski, J., & Stolzberg, J. (1998) Long-term impact of a verbal interaction program for at-risk toddlers: An exploratory study of high school outcomes in a replication of the Mother-Child Home Program. Journal of Applied Developmental Psychology, 19, 267-285. Love, J., Kisker, E., Ross, C., Schochet, P., BrooksGunn, J., Paulsell, D., Boller, K., Constantine, J., Voget, C., Fuligni, A., & Brady-Smith, C., (2002) Making a Dierence in the Lives of Infants and Toddlers and Their Families: The Impacts of Early Head Start, Vol. I, Final Technical Report. Princeton, N.J.: Mathematica Policy Research, Inc., and New York, N.Y.: Columbia Universitys Centre for Children and Families at Teachers College. McCormick, M., Brooks-Gunn, J., Buka, S., Goldman, J., Yu, J., Salganik, M., Sco, D., Benne, F., Kay, L., Bernbaum, J., Bauer, C., Martin, C., Woods, E., Martin, A., & Casey, P. (2006) Early intervention in low birth weight premature infants; results at 18 years of age for the Infant Health and Development Program. Pediatrics, 117(3), 771-780. Mitchel-Herzfeld, S., Izzo, C., Green, R., Lee, E., & Lowenfels, A., (2005) Evaluation of Healthy Families New York (HFNY): First Year Program Impacts. Albany, NY: Oce of Child and Family Services, Bureau of Evaluation and Research and the Centre for Human Services Research, University of Albany. February. hp://www. healthyfamiliesamerica.org/research/index.shtml New South Wales Department of Community Services. (2003) Prevention and Early Intervention Budget Enhancement, October. Nurse Family Partnership (NFP). National oce web site: www.nursefamilypartnership.org Olds, D., Henderson, C., Chamberlin, R., & Tatelbaum, R. (1986) Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78(1), 65-78.

12

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 1

13

ARTICLE
Olds, D., Eckenrode, J., Henderson, C., Cole., R., Kitzman, H., Luckey, D., Pei, L., Sidora, K., Morris, P., & Powers, J. (1998) Long-term eects of home visitation on maternal life course, child abuse and neglect and childrens arrests: Fieenyear follow-up of a randomized trial. Journal of the American Medical Association, 278(8), 637-643. Olds, D., Robinson, J., OBrien, R., Luckey, D., Pei, L., Henderson, C., Ng, R., She, K., Korfmacher, J., Hia, S., & Talmi, A. (2002) Home visiting by paraprofessionals and by nurses: a randomized, controlled trial. Pediatrics, 110(3) September, 486496. Parent Child Home Program (PCHP). National oce web site: www.parent-child.org Parents as Teachers (PAT). National oce web site: www.patnc.org Pfannenstiel, J., Seitz, V. & Zigler, E. (2002) Promoting school readiness: The role of the Parents as Teachers program. NHSA Dialog: A Research to Practice Journal for the Early Intervention Field, 6, 71-86. Reynolds, A., Temple, J., Robertson, D., & Mann, E. (2001) Long-term eects of an early childhood intervention on educational achievement and juvenile arrest: A 15 year follow-up of low-income children in public schools. JAMA, 285(18), 23392346. Schweinhart, L. (2004) The High/Scope Perry Preschoool Study through age 40: Summary, conclusions and frequently asked questions. hp://www.highscope.org/Research/PerryProject/ PerryAge40SumWeb.pdf. Sco, D. (2006) Towards a public health model of child protection in Australia. Communities, Children and Families Australia, 1(1), 9-16. Seitz, V., Rosenbaum, L. & Apfel, N. (1985) Eects of family support intervention: A ten-year follow-up. Child Development, 56, 376-391. Shonko, J. & Phillips, D. (2000) From Neurons to Neighborhoods: The Science of Early Childhood Development. National Academy Press, Washington D.C. Sweet, M., & Appelbaum, M. (2004) Is home visiting an eective strategy? A meta-analytic review of home visiting programs for families with young children. Child Development, 75, 1435 1456. U.S. Department of Health and Human Services, U.S. Advisory Board on Child Abuse and Neglect. (1990) Child Abuse and Neglect: Critical First Steps in Response to a National Emergency. Washington, DC: U.S. Government Printing Oce, August. U.S. Department of Health and Human Services, U.S. Advisory Board on Child Abuse and Neglect. (1991) Creating Caring Communities: Blueprint For An Eective Federal Policy for Child Abuse and Neglect. Washington, DC: U.S. Government Printing Oce. Vimpani, G. (2000) Home visiting for vulnerable infants in Australia. Journal of Pediatric Child Health, 36, 537-539. Vimpani, G., Frederico, M., Barclay, L., & Davis, C. (1996) An audit of home visitor programs and the development of an evaluation framework. Commonwealth Department of Health and Family Services. National Child Protection Council, Canberra. Wagner, M. & Spiker, D., (2001) Multisite Parents as Teachers Evaluation: Experience and Outcomes for Children and Families. Menlo Park, CA: SRI, International. Available at www.sri.com/policy/ cehs/early/pat.html Weiss, H. (2004) The home visit forum: Understanding and improving the role of home visitation. The Evaluation Exchange, 10(2), 19. Weiss, H. (1993) Home visits: Necessary but not sucient. The Future of Children, 3(3), 113-128. Williams, Stern & Associates. (2005) Health Families Florida: Evaluation Report January 1999 December 2003. Miami, FL: Author. hp://www. healthyfamiliesamerica.org/research/index.shtml Giovanna Richmond Lecturer, School of Social Work PhD Candidate Australian Catholic University 223 Antill Street Watson ACT 2602 Phone: +61 2 6209 1186 Fax: +61 2 6209 1174 Email: g.richmond@signadou.acu.edu.au

Creating policy partnerships: The nexus between child health and child protection
Giovanna Richmond
ACKNOWLEDGEMENTS:
I wish to acknowledge the contribution made by my colleagues in ACT Health and the ACT Oce for Children, Youth & Family Support, through our stimulating discussions on the topic of cross sectoral partnerships since 2003. However, the views presented in this paper are entirely mine and do not necessarily reect the views of my colleagues.

ABSTRACT
A major challenge for governments providing health and welfare services is to nd a balance between their protective, statutory functions while at the same time strengthening the focus on prevention, early intervention and family support. This balance is essential if a reduction of child abuse and neglect is to be achieved, but achieving it has proven highly problematic for many countries, including Australia. Health systems have a signicant role in addressing this imbalance. A health systems capacity in working to keep children and young people safe is reduced when a child protection system is predominantly oriented to the tertiary or aer the fact response. Coordination and collaboration in practice across sectors are not enough. An explicit policy is required that is commied to a continuum of care, incorporating prevention and early intervention approaches across the health and child protection systems. With a focus on early childhood, and on the role of established maternal and child health nursing services, this paper takes a critical retrospective view of aspects of a health systems strategy to address Healths role in child protection and presents a conceptual framework with which to beer understand and promote cross sectoral policy development beyond the oen rhetorical subject of improving service integration.

KEY WORDS
Child protection, child health, maternal and child health nursing/early childhood nursing, cross sectoral policy, service integration.

14

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 2

15

INTRODUCTION
Healths role in child protection is widely recognised. Whilst acknowledging this important role for Health at all levels, it is more explicit and accepted at the tertiary end of the system, in the provision of forensic, medical, and specialised therapeutic services. This paper presents the view that the Health response at the primary and secondary levels needs to be broader in scope, and directed by specic policy. The health sectors strategy in Canberra, Australian Capital Territory (ACT), in response to a child protection reform process, will be presented as an example of a policy initiative to demonstrate the drivers for change and the potential to address further development of cross sectoral policy in child protection. I will rstly provide some background information on maternal and child health nursing services in Australia and introduce the ACT context. The paper then explores the current understandings of the role Health plays in child protection and identies key elements for cross sector policy development, concluding with the presentation of a conceptual model for improving service integration.

depression, family planning, identication of failure to thrive, capacity to set up local peer networks such as for teenage mothers and fathers, and working with the mother-infant dyad as well as a family nursing framework (see Erikson, 1996). That is not to say that these functions are exclusive to nursing, however it is the combination of process and context within a primary health care paradigm, that makes it central to prevention and early intervention approaches in child protection. The Australian Primary Health Care Institute has dened primary health care as:
Socially appropriate, universally accessible,

scientically sound rst level care provided by a suitably trained workforce supported by integrated referral systems and in a way that gives priority to those most in need, maximises community individual self reliance and participation and involves collaboration with other sectors. It includes health promotion, illness prevention, care of the sick, advocacy and community development. (Sibthorpe, Glasgow & Wells, 2005)

THE SCOPE OF HEALTH SERVICES

Health covers a very broad range of services many of which are very relevant to child protection. These include maternal and child health nursing, both hospital and community based, GP, midwifery, allied health, and child health specialist services such as paediatrics. Although this paper highlights the role of only one of these, maternal and child health nursing, there are signicant implications for the whole of the health system in supporting a more focused role in child protection at all levels of care. Many other non statutory services play an important role in child protection, such as government and non government community based family support services. I have focused on maternal and child health nursing services in this context because of their unique place in the health system. In all Australian states and territories these services are well established, accepted, and generally universally accessible. Their uniqueness is also about their role in interventions that can lower the risk of child abuse and neglect such as undertaking risk assessments for post natal
16

These principles encompass child protection issues and provide a framework for levels of care and approaches to child health, safety and well being. Although maternal and child health nursing services are currently facing professional issues common to other human services, such as problems in recruitment and an ageing workforce, they are generally supported by a well trained workforce working within a cross disciplinary, collaborative practice framework. New South Wales, South Australia and Victoria for example, have led the way in universal and targeted prevention and early intervention services and also toward the development of advanced competencies and specialised training for maternal and child health nurses, enhancing skills and the knowledge base required for nurses to work with vulnerable families (for example, see Victorian Department of Human Services, 2006). The ACT is typical of most states and territories in the scope and reach of its services. These include infant and school health screening and surveillance; parenting education and support services;

breastfeeding support and early childhood health and development programs. Targeted services focus on vulnerable families who may be aected by drug/ alcohol, mental illness and/or disability, domestic violence, birth complications and maternal health problems. These services reach a very large part of the population group, particularly in the childs rst three years. In 2003 the ACT reported 95% coverage of all newborns for neonatal home visiting within the rst month of hospital discharge (personal communication, 2003). That is, the service reached the vast majority of families with newborns mainly through home visitation. All states and territories have a program of scheduled contacts between families and maternal and child health/early childhood nurses for the purpose of child health monitoring from birth to school age (Eronen, 2003, p. 16). The case is strong for continuing a program of universal screening and surveillance that provides structured opportunities for health promotion, anticipatory guidance and parental support (Eronen, 2003, p.16). Generally the reach to families and the services role decreases however, as the child grows, with the age cohort for services generally accepted as 0-6 years, but other opportunities exist for universal services such as kindergarten screening, where accessibility and the potential for primary and secondary interventions remain high.

year period (AIHW, 2006). The situation has been described as disturbing by the ACT government (Chief Ministers Department, 2004, p. 40). Similar to other states in Australia and countries such as the USA and Canada, the ACT has a child protection system based on a legal framework that includes the provision of mandatory reporting of physical and sexual abuse of children by a variety of public servants and professional workers, a policy of supporting families as far as possible in caring for their children, and a focus on the best interests of the child (Children and Young People Act 1999 (ACT)). Together with other jurisdictions both in Australia and overseas, the ACT has recently undergone an extensive reform process which has included rethinking the policy framework of family and health services in the area of child protection of children and young people. The Vardon review was the key investigatory public process which provided much of the direction and content for the reform of the child protection system in the ACT (Vardon, 2004). A major catalyst for the ACT review, in late 2002, was the death of a child of suspected abuse and the subsequent coronial inquiry (Coroners Court, 2003, cited in Vardon, 2004). Although the coronial inquiry reached an open nding, it placed both the health and child protection sectors in the ACT under signicant political and community pressure to maximise their eorts in protecting vulnerable children. The Vardon review in recommending a child death review process in the ACT commented that the review of the child protection system had taken into account the Coroners ndings which showed a lack of interagency cooperation in the ACT and role confusion across agencies and disciplines (Vardon, 2004). The Coroner had also been presented with a major service improvement strategy, the Refocus strategy, for the child protection system in the ACT (Vardon, 2004). Whilst the bureaucratic response to the coronial was typically, as for post inquiries into deaths of children who have been known to statutory authorities, a presentation of an immediate reform agenda, the general policy environment also provided some impetus for change (Stanley & Manthorpe, 2004). This included, at the territory and national levels, the ACT Childrens Plan 2004-2014, and the National Agenda for Early Childhood 2000, both of which

THE ACT CONTEXT

Canberra, in the Australian Capital Territory, is the capital city of Australia. It has an estimated population of around 320,000 people and a projected growth of approximately 3,000 people per annum for the next 10 years (Australian Bureau of Statistics, 2002). There are around 53,000 children in the ACT under 12 years of age, with an average of 4,000 births per annum (ACT Government, 2002). The population health and well being prole and the social context of Canberra children, generally, are favourable, however, there has been and continues to be signicant concern for some vulnerable children and young people in the ACT. Along with other Australian jurisdictions, the ACT has seen a dramatic increase in the number of child protection reports, those requiring appraisal (that is, investigation) and in the number of substantiations over a four

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 2

17

strongly promoted a cross sectoral approach in the planning and delivery of childrens services. These major strategic overarching policies have drawn on extensive research on the eectiveness of prevention and early intervention approaches. Prevention and early intervention principles and service strategies have been well dened and researched (for example see Sco, 2000; Tomison, 2002; Winkworth, 2003; NSW Commission for Children and Young People, 2004; Holzer, Higgins, Bromfeld, Richardson & Higgins, 2006). Although there is considerable rhetoric around prevention and early intervention approaches in childrens services, there have been some key national prevention and early intervention programs implemented in the health and child protection domains, such as the Stronger Families and Communities Strategy in Australia and SureStart in the UK (Glass, 1999; FaCS, 2004). The Vardon reviews recommendations for system reform reected this research focus and resulted in recommendations for example, to strengthen family support programs. The reviews main priority however, was to address specic issues that related to the treatment of children in public care and also the administrative and management issues in child protection in the ACT (Vardon, 2004). As a result, the reform process focused mainly on broader structural, budgetary and administrative changes to strengthen the regulatory part of the child protection system. The remainder of the paper analyses within the above policy environment, a specic cross sectoral response to the Vardon review rather than an analysis of the reform process per se. It focuses on the ACT health sectors immediate response to the Vardon review (inclusive of private sector health services such as General Practitioners) which has been a starting point for a revisiting of Healths roles and responsibilities in child protection. The task for the ACT health system was to develop a clearly articulated policy which would provide the basis for developing a much stronger role at all levels in child protection. There is no shortage of research and practice evidence supporting the view that the health sector is generally, well placed to understand and respond to the needs of vulnerable children and families (for example see, UK Every child maers, 2003; Crisp & Green Lister, 2004). The next section
18

of this paper discusses the role of the health sector in the child protection system.

THE ROLE OF HEALTH PRACTITIONERS IN CHILD PROTECTION

In Australia, the role of health services generally in the area of child protection has been described as services that support the assessment of child protection maers, and deliver therapeutic counselling and other services (AIHW, 2006, p.2). However, there is substantial evidence that emphasises the important roles played by health professionals and the health sector across the continuum of care, in child protection (for example see Marchand, Davidson, Garcia & Parsons, 1991; Hommel, 2000; Eronen, 2003; Crisp & Lister; 2004; Sco, 2006). There is also evidence of major concerns that arise from confusion and conicts that surround discrepancies between the actual and perceived roles of health professionals in the area of the care and protection of children (for example, see Hanan, 1998). An example is the uncertainty that is experienced by nurses in their role in child protection. Over the past two decades, research on the role and eectiveness of nursing interventions has conrmed the importance of nursing, and in particular, community based nursing and health visiting for the care and protection of children. As previously stated nurses may legitimately and eectively intervene to reduce the risk factors that can contribute to child abuse and neglect. However, they have reported uncertainty about their actual and perceived roles in the area of child protection. For example, Crisp and Green Lister identied concerns among community nurses in Scotland, about the lack of consensus on child protection policies (2004). The study explored nurses understanding of their professional responsibilities in relation to child protection and the potential for nurses to be involved in protection of children from abuse and neglect. It concluded that there was a lack of consensus among nurses about their roles in child protection. There was also identied conict between their family support roles and the detection of child abuse and neglect. A UK study by Gilardi (1991) showed that in 42 % of cases the health visitor (with a similar role to home visiting by maternal and child health nurses

in other countries) was the rst to suspect abuse. However, the majority of health visitors reported uncertainty about their role in assessment of risk and indicated that they had inadequate training to deal with the abuse issues (Gilardi, cited in Browne, 1995). Many of the health roles identied by the nurses in these studies as child protection roles, such as family support, monitoring of mothers and childrens health, and service development are however, clearly within the remit of accepted public health roles (Eronen, 2003). As a universal service in the UK and in many other jurisdictions including the ACT, they are able to oer help and support to parents without stigmatising the family as a problem family. Browne suggests that an enhancement of the role of community nurses in the prevention of child maltreatment is required whereas limiting their role will result in a higher number of hospitalised children with cases of serious abuse and neglect (1995). US research by Olds, OBrien, Racine, Glazer & Kitzman, provides sound evidence of the role of home visitation by nurses in eectively promoting parental competence and self condence in dealing with the care and management of children (1998). These interventions have been shown to improve mother/child play, reduce physical punishment and reduce abuse and neglect. Child health researchers have emphasised the importance of optimal maternal health even before conception, because the foetal brain cell development starts well before the mother knows she is pregnant (Comley & Mousmanis, 2003 cited in Eronen, 2003). Pregnancy and early childhood are critical periods for the promotion of health and development of children, as:
The earliest years of life are accompanied by the highest risk for physical abuse and neglect and almost all fatalities due to child maltreatment occur in the rst three years of life (Hunter, 2005, p. 373).

been identied and supported by the public health literature include: screening and identication of risk factors and developmental problems; risk reduction through education, support, treatment and referral; monitoring and ongoing care; advocacy and developmental enhancement through individual and community education and development (Comley and Mousmanis cited in Eronen, 2003). In public health, maternal and child health nurses both internationally and in Australia have played a crucial role in the reduction of infant mortality during the last century (Ferguson, 2003; Eronen, 2003), and there is a growing interest in the role that could be played by maternal and child health nurses in this area (Crisp & Green Lister, 2004).

REVIEWING HEALTHS ROLE IN CHILD PROTECTION

In the ACT, a policy partnership was forged between Health and child protection as an immediate response to the coronial inquiry and to the broader reform process. This was initially a risk management initiative which was focused on the role of Healths professional workforce as mandated reporters of child abuse. Changes were made to Healths policies and procedures that beer complied with child abuse reporting requirements and more comprehensive training policies were also developed. Prior to the coronial inquiry and the Vardon review, no formal child protection policy existed within Health. What did exist was concerned mainly with mandatory reporting policies and procedures specic to individual health services such as The Canberra Hospital (a major teaching hospital). They were generally in need of a major review. A new whole of health sector joint child protection advisory commiee was established that connected all Health areas and child protection in a policy and practice partnership. Its purpose was to specically develop a comprehensive joint child protection policy for the whole of the health sector in the ACT. The role and importance of advisory commiees

When intervention takes place in a forensic based child protection system, it is generally aiming to reduce further risk and harm to the child. The earliest interventions are in the scope of the public health system and in particular, within the child health system. Some specic interventions that have

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 2

19

in human services has been well researched and they have been found to promote cross sectoral collaboration, and contribute to evidence based decision making for population groups (for example see Armstrong, Doyle, Lamb & Waters, 2006). There is no legislation in the ACT that denes a holistic system of care for vulnerable children that is inclusive of the health and other sectors roles in protecting children. In this context, in the absence of legislation, an important step in building eective systems of care for vulnerable children is the establishment of policy across administrative spheres of government (Friedman, 2001). In the public policy literature, cross sectoral and interdepartmental coordination and consultation generally, as well as the use of representative commiees, have been identied as sound strategies for comprehensive policy development and good outcomes (Edwards, 1998; Bridgman & Davis, 1998). An initial outcome of the partnership was the development of a comprehensive child protection training strategy for all health professionals. The training policy shied the responsibility of training Health sta on child protection policies, procedures and competencies, from the statutory authority to the health sector. Health, by taking ownership for the development of this policy, contributed to an enhanced focus on child protection issues. It also resulted in an increased investment in child protection by Health. For example it meant: the establishment of discrete child protection training positions; the creation of two inter sectoral liaison positions; increased funding for the tertiary service, the Child at Risk Assessment Health Unit; enhanced interdisciplinary integration such as the introduction of nursing positions in the Child at Risk Unit (personal communication, July, 2006). This process created the beginnings of an explicit policy for Health in child protection, which extends the role of the health worker from someone who navigates the child protection system (through procedures) to someone who is an integral part of

it (ACT Health Child Protection Policy, 2006). The unintended consequence of a system of mandatory reporting that potentially, abrogates responsibility from health worker to statutory worker, can result in isolation of many health professionals and as a consequence, experiences of conict between the role of caring and control. A UK commentary by Mummery on a study of South Australian nurses decision making in cases of suspected child abuse and its relevance to UK practice highlighted the conict between care and control in nurses experiences (Nayda, 2002). She states that:
The mind shi is perhaps from that of a duty to report, as in Australia, to a duty to keep the childs needs paramount, as in the UK. This is fundamental to our practice and aords a continuum of care through the recognition, referral and intervention stages of work with the family. For the caring profession, a duty of care sits more comfortably than a duty to report (2000).

interdisciplinary and inter sectoral work in tackling child abuse and neglect. The UK has been at the forefront in developing cross sectoral child protection policy and since the publication of the Messages from Research in 1995, the policy and practice direction has been toward interagency working and an the integration of health and social care (Department of Health, 1995). The UKs most recent social exclusion national policy Every Child Maers, continues to support signicant roles for health personnel in the safeguarding of children and young people (Department of Education & Skills, 2005). Eective development of cross sectoral policy and practice should lead to a greater clarity of roles and responsibilities of service providers. Considerable research has been conducted on roles and responsibilities of many groups involved in the safeguarding of children and young people. Statutory workers, Health, Education professionals and in the private sphere, the role of parents/ carers and communities have been examined and these studies provide useful knowledge about the protection activities that occur beyond direct state interventions (Davies, Krane, Rains & Mastronardi, 2002). Studies focused on public sectors workforce identify dierences in work cultures, training requirements, and how best to promote inter sectoral and interdisciplinary collaboration (for example see Daniel, 2004; Crisp & Green Lister, 2004). A UK study found that the mismatch between actual and perceived roles of nurses in their work with young families and children can lead to practices which undermine rather than support child protection. Lack of clarity about the role of the public health nurse was found to reduce referrals to specialist tertiary interventions. As the ...nurse fulls a range of prescribed roles ... there is a perception or expectation among other service providers that she is also fullling additional roles (Hanan, 1998 p.2). There are signicant dierences in roles and responsibilities in professional and agency accountability for child protection. Generally, child protection workers are accountable through legislation and agency, whereas Health sta generally, are accountable, within the domain of safeguarding children, through the mandatory reporting process. This can lead to health workers, for example,

KEY ELEMENTS FOR BETTER INTEGRATION

In this case example, I have discussed some drivers for change, such as the Coronial inquiry, that has led Health to review its role in child protection. What then are the key elements and the associated barriers that can direct the next steps toward a more comprehensive policy, aimed at achieving a beer balance of prevention, early intervention and tertiary approaches? I have identied three key elements from the literature that can provide the impetus and justication for Health and child protection to further develop and implement a cross sectoral child protection policy: role denition and alignment; shared understanding of evidence based policy and practice; eective mechanisms for action. Each of these elements is discussed in more detail below.

seeing their statutory role as mandated reporters as potentially in conict with other expectations in terms of supporting families. Specically, it is the potential conict of a surveillance role and a support role (Scoish Executive, 2000). However in Health, the surveillance and monitoring of children, is a positive worldwide strategy. This strategy is manifested in universal and targeted maternal and child health programs that have achieved good outcomes in reducing abuse and neglect by promoting health and development and through the provision of parent education and support (Olds, et al., 1998; Sanders, 2003; Hunter, 2005). Sanders has argued for example, for a comprehensive population based strategy to enhance parental competence, prevent dysfunctional parenting practices, change parental aitudes and promote beer teamwork between partners, thereby reducing an important set of family risk factors associated with child abuse and neglect (Sanders, 2003). Most recently, Sco has advocated for a primary care approach and a public health strategy to reduce the incidence and prevalence of child abuse and neglect in communities (Sco, 2006). This would lead to an increased government commitment to universal and targeted approaches: in the future, Health approaches will be considered to be an integral component of a truly comprehensive child protection service (Crisp & Green Lister, 2004). Health professionals roles could be further aligned to current approaches in child protection to provide a broader and more integrated approach across the health and child protection sectors. For example, more integrated approaches could be developed in home visiting programs, child health clinics, schools and youth health centres. The eectiveness of health professionals interventions requires a policy context that formally identies, promotes and supports Healths role and responsibilities in safeguarding children.

SHARED UNDERSTANDING
Discipline and sector based cultural dierences need to be taken into account when developing a system of shared responsibilities for child protection. Pei et al., state that in the absence of compatibility between sectors, the eectiveness of policies that
21

ROLE DEFINITION AND ALIGNMENT

Policy development in this area falls short of reecting the reality of day to day practice and the potential of

20

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 2

are established in any single sector is likely to be diminished (Pei, Phillips, Williams Killen & Jackson, 1996, cited in Friedman, 2001). Language and styles of communication are cultural factors that impact on role perceptions and denitions, the meaning of evidence in policy and practice in dierent sectors, and collaboration (Armstrong, et al., 2006). A dialogue that recognises the importance of this key element in cross sector work is at the centre of increasing awareness and clarication of roles and responsibilities in child protection. I argue that developing a shared language is integral to developing an eective cross sector policy and practice in child protection. This would promote clearer understanding and acceptance of a common ground based on roles and responsibilities, competencies and shared principles and values. It could include child centred practice, the meaning of establishing family partnerships and relationships with children and families, surveillance and monitoring, and a beer understanding of what are child protection interventions. This has the potential to break down apprehension, cross discipline and cross sectoral conicts, and build trust and condence in the system. Shared training and the co location of sta across sectors can improve cross sectoral communication but it also requires an understanding and commitment to a shared policy and to research and practice evidence (Armstrong et al., 2006). This would include knowledge that enhances joined up thinking and doing and collaboration such as: an understanding of the complexity of the causal and risk pathways of dysfunction and child abuse (Hommel, 2000; Stanley, Sanson & McMichael, 2002, cited in Eronen, 2003); an increased understanding of public health approaches; and of the contribution of epidemiology. This is more likely to lead to a continuum of care and knowledge of incidence and prevalence of child health concerns including child abuse and neglect (Sco, 2006). Shared understanding and direct child protection training of sta however, are not enough. There is a need for ongoing support and dedicated leadership in health and child protection to ensure that role confusion and conicts are identied and managed eectively (Woodhouse & Pengelly, 1991).
22

EFFECTIVE MECHANISMS FOR ACTION

At the administrative level, the health and child protection sectors in the ACT have developed some eective mechanisms to enhance integration in the delivery of evidence based services. A number of cross sectoral advisory and consultative commiees exist that are accountable for outcomes in child health and child protection (Vardon, 2004; ACT Childrens Plan, 2004). These facilitate shared responsibility and are more likely to lead to joined up thinking and doing (Armstrong, 2006). Alteration of institutional structures is another strategy that could enhance cross sector responsibility for child protection (Daro, 2006). Both these strategies should be based on a commitment to a sustainable resource base that is linked to outcomes of cross sectoral interventions. For example, home visiting programs have been shown to be successful, that is, reducing the incidence of child abuse and neglect, where the focus was on improving both maternal and child health and well being. This requires multi-agency and cross discipline policy and practice collaboration (Holzer, Higgins, Bromfeld, Richardson & Higgins, 2006. There is considerable literature on the relationship between policy and implementation that can inform organisational practices. A key element in service integration is the development of public policy that directs and guides the structure of the service delivery systems and ultimately its outcomes (Friedman, 2001). These three key elements are inextricably linked and are central to improving cross sectoral integration of policy and practice. I have developed a conceptual framework that incorporates these key elements. The next section of the paper discusses a conceptual framework for improving sectoral integration. In the framework, child protection encompasses the statutory authority, its workforce and services and child health represents government services and workforce (also private services such as GPs) that are hospital and community based providing services to children and families. This framework identies a strong, positive nexus between child health and child protection systems in the prevention and early intervention approaches. Understanding and acting upon the benets of this

REFERENCES
Armstrong, R., Doyle, J., Lamb, C. & Waters, E. (2006) Multi-sectoral health promotion and public health: the role of evidence. Journal of Public Health, 28(2), 168-172. Australian Bureau of Statistics (ABS). (2002) Australian Capital Territory in focus, 2001. (No. Cat. No. 1307.8). Canberra; [cited 1 July, 2006]. Available at: hp://www.abs.gov.au Australian Capital Territory. Chief Health Ocer. (2002) ACT Chief Health Ocers Report 20002002. Canberra: Population Health Division: ACT Government, Canberra. Australian Capital Territory. Chief Ministers Department. (2004) Building our Community: The Canberra Social Plan, ACT Government, Canberra. Australian Capital Territory. Chief Ministers Department. (2003) ACT Childrens Plan: 20042014. ACT Government, Canberra. Australian Capital Territory. Health Child Protection Policy. (2006) v.2. The roles and responsibilities of ACT Health sta. ACT Government, Canberra. Australian Institute of Health and Welfare. (2006) Report: Child Protection Australia 2004-2005. (No. no. cws26). [cited September, 2006]. Available at: hp://www.aihw.gov.au Browne, K. (1995) Preventing Child Maltreatment Through Community Nursing. Journal of Advanced Nursing, 21, 57-63. Cooper, A. (2005) Surface and Depth in the Victoria Climbie Report. Child and Family Social Work, 10(1). Crisp, B. & Green Lister, P. (1998) Child protection and public health: nurses responsibilities. Journal of Advanced Nursing, 47(6), 656. Daniel, B. (2004) An overview of the Scoish multidisciplinary child protection review. Child and Family Social Work, 9(3), 247. Daro, D. (2006) Unpublished paper: World Perspectives: Generating a National Prole on Child Abuse. Presented at ISPCAN Conference, York, UK. September, 2006.

nexus would require an explicit cross sectoral policy, the identication of key elements and barriers to improve cross sector integration and the eective management of boundaries between health and child protection domains. These boundaries are professional, discipline and policy based but they are also indistinct and permeable and therefore there is potential for change and development (Woodhouse & Pengelly, 1991).

CONCLUSION
This paper has focused on integrated policy development in the area of child health and child protection. I have argued that there is potential to enhance a healths systems role in child protection through the development of specic cross sectoral child protection policy. There are public policy initiatives and substantial research and practice evidence to support the development of healths role in child protection but in reality signicant professional, structural and practice barriers exist. This paper has presented a conceptual framework for ways of working to improve service integration and a range of strategies to address these barriers and to increase the benets of cross sectoral policy development. The strength of this approach lies in the potential of policy partnerships that can generate shared meaning across professional and structural paradigms, breaking down the barriers that reduce the capacity and responsiveness of the workforce, services and community resources.

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 2

23

Davies, J., Krane, J., McKinnon, M., Rains, P. & Mastronardi, L. (2002) Beyond the state: Conceptualising protection in community seings. Social Work Education, 21(6). Erikson, M.E. (1996) Factors that inuence the motherinfant dyad relationships and infant well being. Issues in Mental Health Nursing, May-June, 17(3) 185-200. Eronen, R. (2003) Unpublished report: Child Health Monitoring Project. ACT Health, Canberra. Department of Family and Community Services. (2003) Toward a National Agenda for Early Childhood. [cited on 12 July, 2006]. Available at: hp://www.facs.gov.au/internet/facsinternet.nsf/ family/early_childhood.htm Ferguson, H. (2004) Protecting children in time: Child abuse, child protection and the consequences of modernity. Palgrave, Macmillan, New York. Friedman, R.M. (2001) A Conceptual Framework for Developing and Implementing Eective Policy in Childrens Mental Health: Research report. Research Centre and Training Centre for Childrens Mental Health, Department of Child & Family Studies, South Florida. Hanan, S. (1998) Deconstructing the role of the public health nurse in child protection. Journal of Advanced Nursing, 28(1), 178. Holzer, P.J., Bromeld, L.M., Richardson, N. & Higgins, D.J. (2006) The eectiveness of parent education and home visiting child maltreatment prevention programs. Child Abuse Prevention, 24, 1-23. Hommel, R. (2000) Pathways to Prevention. National Crime Prevention Strategy, Australia, Canberra. Hunter, W. M. (2005) A New Paradigm for Child Protection: Begin at the beginning. NC Med J, 66(5), 373-379. Marchand, S.D., Garcia, J. & Parsons, J.E. (2001) Addressing domestic violence through maternity services: policy and practice. Midwifery, 17(3), 164170.

Mummery, S. ( 2002) Invited Commentary: Inuences on Registered Nurses Decision Making in Cases of Suspected Child Abuse-Relevance and Implications for UK practice. Child Abuse Review, 1(11), 179-181. Nayda, R. (2002) Inuences on registered nurses decision-making in cases of suspected child abuse. Child Abuse Review. 11(3) 168-178. New South Wales. Commissioner for Children and Young People. (2004) A Head Start for Australia: An early years Framework. Brisbane, Australia. Olds, D., OBrien, R.A., Racine, D., Glazner, J., & Kitzman, H. (1998) Increasing the policy and program relevance of results of randomised control trials of home visitation. Journal of Community Psychology, 26(1), 85-100. Powell, C. (1999) Child Protection: The crucial role of the childrens nurse. Paediatric Nursing, 9(9), 13-16. Sanders, M.R., Cann, W. & Markie-Dadds, C. (2003) Triple P- Positive Parenting Program: A population approach to promoting competent parenting. Australian e-journal for the Advancement of Mental Health, 2(3). Sco, D. (2000) Embracing what works: Building communities that strengthen families. Children Australia, 25(2), 4-9. Sco, D. (2006), Towards a public health model of child protection in Australia. Communities, Children and Families Australia, 1(1), 9-16. Scoish Executive. (2001) For Scotlands Children: Beer Integrated Childrens Services. Scoish Executive, Edinburgh. Sibthorpe, B.M., Glasgow, N. J. & Wells, R.W. (2005) Questioning the sustainability of primary health care innovation. Supplement. MJA, 183(10), S52S79. Stanley, F. (2003) The real brain drain: Why puing children rst is so important? Auseinet, 19(3), 6-10. Stanley, N. & Manthorpe, J. (eds). (2004) The Age of Inquiry: Learning and blaming in health and social care. Routledge, Taylor & Francis Group, London & New York.

Steinberg, A., Benne Woodhouse, B. & Cowan, A. (2002) Child-centred, vertically structured, and interdisciplinary: An integrative approach to childrens policy, practice and research. Family Court Review, 40, 116-134. Tomison, A. (2002) Preventing child abuse: Changes to family support in Studies, Melbourne. UK Department of Health & Skills. (2005) Every Child Maers: Change for Children. HMSO, London. Vardon, C. (2004) The Territory as Parent: Review of the Safety of Children in Care in the ACT and of the ACT Child Protection Management. ACT Government, Canberra. Victorian Department of Human Services. Maternal and Child Health Nursing Program Standards report. (cited on 28 October, 2006) Available at: www.oce-for-children.vic.gov.au. Winkworth, G. (2003) Puing childrens services in their place: A call for universal childrens services to prevent child abuse and neglect in Australia. Children Australia, 28(1), 1-16. Woodhouse, D. & Pengelly, P. (1991) Anxiety and the Dynamics of Collaboration. Aberdeen University Press, Scotland. the 21st Century. Child Abuse Prevention. 17. Australian Institute of Family

24

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 2

25

ARTICLE
for more exible and innovative approaches to resolving problems within families. The promotion of participatory practice required greater autonomy and authority to negotiate options and seek common ground with family networks. However, by the end of the decade in many English speaking countries services had become more restricted, conservative and procedure-bound as a result of a complex interplay of political, organizational and professional pressures. Despite the rarity of deaths, fear of child homicide strongly inuences services that are provided for at risk children. High prole child death reporting has thus become one of a set of reinforcers that has inuenced risk-averse practices in recent years. Closely linked to high prole reviews is the media response to them that creates high prole aention to abuse and oen an alarmed community reaction. Recent research into media aention and the number of child protection referrals received by statutory child protection services reveals a close correlation (Mansell, 2006). Periods of high levels of media aention have been found to coincide with higher referral rates. Indeed, it would seem that periods of extreme growth in notications follow the most intensive periods of media aention. Finding ways of learning from child deaths without them becoming a mechanism for promoting more conservative, risk averse practice has become a key challenge for child welfare systems in recent years. As an alternative to examining individual child deaths, this paper analyses a small number children who, at the time of their death, were known to statutory child protection services in New Zealand from 1996-2000. A document analysis has been used to illuminate the issues with respect to child care and protection intervention processes1. With respect to child death reviews, document analysis illuminates the complex interplay of family, community, professional and organisational systems that are involved in these tragic outcomes for children.2 We would argue that identifying the professional complexities surrounding situations of child death when distanced from the death itself, is more likely to inform professional and organisational systems and their responsiveness to children at risk. However, before we go on to discuss the case studies, because we are using New Zealand cases, we will provide some context to the ways in which NZ statutory services seek to protect the safety needs of children. Statutory child care and protection in New Zealand The New Zealand approach works to inform, encourage and persuade people to recognize the signs and symptoms of ill treatment and to report their concerns, ensuring legal protection for all who do so in good faith. This approach contrasts with mandatory reporting requirements in the United States and most states of Australia, but is similar to the process followed in the United Kingdom. Statutory ocials social workers and police - have powers to take emergency action to protect children, to arrange medical examinations and to gather information relevant to their enquiries. Typically concerns about children are received and assessed by a social worker, aided by a set of guidelines. On the basis of this assessment a decision is made whether the notication meets the threshold for statutory intervention. This generates a number of initial response issues. On the one hand it is important that a family not be subjected to unnecessary investigation. Investigations are intrusive and can have a destabilizing eect on a family. Care needs to be taken not to overestimate the risk for a child and inappropriately err on the side of caution. On the other hand, underestimating risk can also have serious consequences:

Child deaths and statutory services: Issues for child care and protection
Marie Connolly
AUTHOR
Dr Marie Connolly holds the position of Chief Social Worker within the New Zealand government. Previously she was Associate Professor and Director of the Te Awatea Violence Research Centre at the University of Canterbury. Her research interests include child and family welfare and in particular participatory practice with families in child protection. She has a social work background in statutory child welfare. Mike Doolan was formally Chief Social Worker within the New Zealand government and is currently Adjunct Senior Fellow at the School of Social Work and Human Services at the University of Canterbury. His research interests include kinship care and child homicide and its coincidence with child protection practice.

ABSTRACT
This article discusses the analysis of nine cases of child homicide that were known to statutory child protection services in New Zealand from 1996-2000. The case studies reveal that few of the deaths were, in fact, predictable. The article discusses the issues raised by the case studies and the reviewing of child deaths more generally. The need for child welfare systems to nd ways of learning from child deaths reviews without them becoming a mechanism for promoting risk averse practice is discussed.
Marie Connolly Chief Social Worker Department of Child, Youth and Family Wellington 6310 New Zealand Phone: +64 0508 326 459 Fax: +64 9 9141 211 Email: marie.connolly005@cyf.govt.nz Mike Doolan ONZM, MSW Adjunct Senior Fellow School of Social Work and Human Services University of Canterbury Private Bag 4800 Christchurch 8140 New Zealand Phone: +64 3 366 7001 Email: mike.doolan@clear.net.nz 26

INTRODUCTION
Child homicide represents the most extreme form of child abuse. Fortunately such deaths are rare, and those known to statutory services even rarer. Nevertheless when they do occur they can be devastating for everyone involved, including the professionals who work with the children. Writers have raised questions about the potential negative eects high prole child deaths can have on practice (Munro, 2005; Sco, 2006; Connolly & Doolan, 2006). A child protection system that is risk-averse and defensive is likely to result in increasing numbers of children moving into care, an approach which is clearly not risk-free for children (DHSS, 1985; Packman, Randall and Jacques, 1986; Berridge and Cleaver, 1987; Triseliotis, 1989). Managing ambiguity and educated risk-taking are key components of child care and protection social work. During the early 1990s many jurisdictions called

The data comprised case review reports compiled following the deaths the children who made up the study sample, with reference made to primary case records where greater detail was sought. 2 The document analysis of case review les is informed by case study theory (Stake, 1995). The cases were studied for instrumental rather than intrinsic purposes, i.e. to establish paerns or insights to aid general understanding, rather than build knowledge about the details of the cases themselves The methodology allows for interpretative, as opposed to assertive, reasoning.
27

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 3

Figure 1: Response decision following notication of potential abuse. 1. Overestimates seriousness and refers to local social worker for investigative action. Possible risk to family: unnecessary intrusion, potential destabilization and risk to child. Risk to agency: too low a threshold results in system becomes overburdened by too many referrals/investigations.

Figure 2: Potential investigative responses following abuse referral. 1. Overestimation of the immediate risk to child results in use of extreme statutory power and the child is removed from the care of family inappropriately or prematurely. Possible risk: child is alienated from family, attachment bonds are unnecessarily broken and the child is subjected to an uncertain care future and longer-term damage. Engagement with the family is lost and also potential for enhancing longer-term safety and security outcomes for the child within the family system. 2. Response reects a balancing of child protection and family support needs. Risk of longer-term harm to the child is balanced against risk of further abuse. The situation is responded to according to departmental policy and an appropriate investigation plan is in place. Notwithstanding the quality of the risk assessment violence toward children can be unpredictable and intervention does not, therefore, guarantee safety. 3. There is a lack of decisive child protection action. Delays in allocation may occur because of resource limitations. Practice gray areas or inadequate information inhibits the social workers capacity to move the case forward. The investigation drifts creating greater risk of the family being destabilized and the child remaining unprotected. Situation may change without reassessment. 4. Risk to the child is underestimated: child may not be sighted within reasonable timeframe; attention to the need for an identied protector is underestimated; undue reliance on earlier assessments versus fresh look at the situation; critical information is not accessed or shared; too little attention is paid to the particular vulnerability of the very young child; procedures are not appropriately followed.

Response decision

2. Assessment of risk meets appropriate threshold for statutory response 3. Underestimation of seriousness and does not accept report for further investigation. Possible risk: child does not receive a level of necessary statutory protection and is injured. Risk to agency: perceived as unresponsive and/or incompetent to deal with children at risk.

In the event of a referral being accepted for further follow up, a measure of criticality is also applied. This establishes a level of response urgency. The child may be assessed as being in signicant danger and under these circumstances the recommended response will be immediate. However, while assessed as at risk, the child may have protectors (for example, a protective grandparent) or the child may be under interim protection within a safe placement. These circumstances moderate the risk and the response urgency measure applied is likely to reect this assessment. A decision that a report requires further enquiry by a statutory social worker launches a process of intervention that is guided by the New Zealand care and protection practice framework (Connolly, 2006). This involves three phases of the child care and protection process: engagement and assessment, seeking solutions with the family, and securing safety and belonging for the child.

children to investigative activity. A joint process with the police avoids multiple interviewing of children and can satisfy the evidential requirements for both civil and criminal purposes. However, the majority of child physical abuse notications are responded to directly by the social worker. Statutory social workers have the power to secure a childs safety if necessary. This requires a careful consideration of the care and protection needs of the child within the context of supporting the family. Again intervention within this phase raises a number of response issues. Undue application of statutory power may result in a child being inappropriately or prematurely removed from the family and subjected to care disruption and interference with familial aachment bonds. Taking children into alternative care can injure future life chances by subjecting the child to potential placement changes, cultural dislocation, and an uncertain future. This needs to be balanced against the risk of possible further abuse. Of course, child protection work is a complex endeavour and practice rarely falls straightforwardly in one or other of these responses. More typically social workers respond exibly as the situation progresses and an intervention pathway is established. Intervention focus shis as information is gathered about the childs situation. Things can move quickly from low to higher risk for the child, or conversely can become less worrying as the situation claries. The second phase of the New Zealand child

Investigative response

protection process involves seeking solutions once concerns have been identied.

SEEKING SOLUTIONS
Following the engagement and assessment phase of the child protection process, if a social worker forms a belief that the child is in need of protection he or she is required by law to refer the child to a care and protection coordinator in order that a Family Group Conference (FGC) is convened. In instances where workers do not form a belief that there is a need for care or protection (for example, the concerns are not considered to involve the risk of signicant harm) but there is a need for services of some kind, less formal interventions are possible. A service agreement may be entered into that provides support for the

ENGAGEMENT AND ASSESSMENT

In eect, the rst phase of the work, engagement and assessment, involves a child protection enquiry, or investigation, that is undertaken by a statutory social worker. Serious allegations of sexual or physical abuse, where perpetrator identication is likely to lead to a criminal justice response, more typically involve Police working jointly with a social worker to plan an investigation and collect evidence. This joint process is aimed at limiting the exposure of

family (called a Family/Whanau Agreement), or workers may encourage families to use alternative legal options to address the concerns. No studies have been undertaken to ascertain the eectiveness of these alternative interventions as a means of resolving lower level care or protection concerns in New Zealand. However, a small qualitative study of ve deaths resulting from non-accidental injury in New Zealand found that two deaths occurred in the investigation phase, one while a child was subject to a Family/Whanau Agreement, and two happened aer the agency had ceased involvement with the children and their families. None had experienced a family group conference (Kinley & Doolan, 1997). The seeking solutions phase of the work also presents practice issues that may impact on the care and safety
29

28

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 3

Figure 3: Potential solutions following a child protection investigation 1. Capturing the family in the child welfare net may not provide for the particular needs of the family, and may represent an excessive and/or unnecessary service response. Alternative legal options may be more appropriate to the familys needs and may foster a greater sense of family care and responsibility. Potential risk: that the solution does not provide adequately for the safety needs of the child. 2. A service agreement may provide a less intrusive level of support for parents to protect the care and safety needs of the child. Potential risk: that the child may be isolated within the nuclear family context and may not benet from the additional support and monitoring provided by an extended family response. 3. A Family Group Conference provides the parents with extended family support, also providing a greater number of adults that can provide care and safety monitoring. Potential risk: poor FGC planning fails to harness the full strength of the extended family; insufcient or poorly organized information is presented at the FGC compromising sound decision-making; family disharmony or intimidatory family dynamics compromise sound decision-making; FGC plans are not reviewed within expected timeframes.

Figure 4: Longer-term intervention options for children at risk 1. The placement of children within systems of non family care may seem to represent the safest option with respect to child homicide risk. In fact they may not provide safety and are unlikely to provide for the childs longer-term security needs. Potential risks with respect to alternative systems of care: alienation of the child from family support and cultural systems; child experiences drift in care and/or multiple placements that are damaging to wellbeing; placements may not be adequately vetted and/or there may be a shortage of adequate caregiver placements. 2. Kinship placements may provide longer-term safety and security for the child and such placements are strongly supported by the New Zealand legal scheme. Nevertheless, placements may not achieve the perceived ideal parenting environments often characterized by non-family caregiver arrangements. Potential risk: caregiver support is inadequate; family alliances undermine the childs safety needs; placement is not adequately vetted or monitored; social worker is not prepared to tolerate less than ideal placement environment. 3. Supporting parents to safely care for their children is likely to represent the ideal option for children, and is also strongly supported in New Zealand law. Potential risk: parents are unable to provide the minimum necessary to secure the safety of the child in the longerterm; support services cannot be maintained; child is subjected to multiple care systems and re-notications. primacy of family responsibility with respect to the development of plans for the childs future. Social workers are expected to support the plans developed by the family unless they seriously compromise the safety needs of the child. What constitutes serious is a maer of professional judgment and in practice is weighed up in the context of what is considered most benecial for the child in the longer term. Again placement solutions bring their own set of benets and risks: Decisions reect ne practice judgments that aempt to negotiate the best interests of the child in the context of both short and longer-term benets and risks. known to systems of statutory child protection. However, when we looked at child homicide within the period 1996-2000 in New Zealand, we found only 20% of all child homicide cases were children known to the statutory child protection system. This percentage is similar to that found in Australia where it has been estimated one in four families had prior contact with child protection authorities (Lawrence, 2004). However, other countries report much higher rates of prior contact, possibly reecting dierent denitions of what constitutes a child protection service (Connolly & Doolan, in press). The summary of data in Table 1 provides the gures of all deaths in New Zealand, and those known to the statutory child welfare system during the period under study.

Solution focused responses

Securing safety and belonging

needs of the child. New Zealand practice strongly supports the development of family solutions for children who are considered to be at risk. Indeed, New Zealand law requires that social workers use minimally disruptive interventions in ways that strengthen family cohesiveness and connectedness. This includes respecting the familys capacity to resolve the issues themselves, and in this regard the use of alternative legal options provides a degree of independence, and may well be highly responsive to the needs of the family. Nevertheless, such options may fall short of the kind of child safety monitoring required by some family situations. Service agreements can provide the kind of support needed for parents to resolve child protection issues, but may not have the eect of harnessing the contribution of the extended family and the additional support and monitoring that the extended family can provide through the mechanism of the FGC. Thus each solution brings with it its own set of benets and risks. In essence, solutions become practice judgments based on the particular needs and circumstances of
30

the child and his or her family. A solution that works well in one family may fail to secure child safety in another. Finally, the New Zealand practice framework identies securing safety and belonging as the third phase of the child protection process.

SECURING SAFETY AND BELONGING

Securing safety and belonging for children may involve supporting the child within the context of family care, or may involve placement with alternative caregivers. As noted earlier, New Zealand law reinforces the need to retain children within the context of their family system, and in practice all social work eort supports this aim. In general this is because family is beer able to provide for a childs longer-term needs both with respect to stability and the childs sense of identity and belonging. Inevitably, however, this produces tensions as social workers negotiate the risk in the context of child placement. An important aspect of the New Zealand legal scheme is the support given to the

CHILD DEATHS AND STATUTORY SERVICES IN NEW ZEALAND

There is a widespread public assumption that the children who die as a result of homicide will be

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 3

31

Table 1: Homicides of children 14 years and under 1996-2000 and numbers of these known by the New Zealand statutory child protection services prior to death. Year All deaths Known to statutory services 1996 0 53 1997 13 2 1998 8 3 1999 12 3 2000 9 1 Totals 47 9 The document analysis of the les for these nine children revealed that they were aged from 8 months to 12 years. Two were under one year of age, and six of the nine children were under 5 years. Six were Maori and three Caucasian. Five were boys and four were girls. None of the children died as results of acts of omission, but rather all were killed by aggressive actions. The majority of the ten perpetrators were men (n=7). Half were de facto parents4, 3 were fathers; and 2 were mothers. Hence all these were cases of

intrafamilial homicide. Five of the nine cases were licide, 2 by mothers and 3 by fathers. The other four deaths occurred at the hands of the parents de facto partner, and in one other case a de facto partner was jointly charged with the childs mother for the homicide (hence the count of 10 perpetrators for 9 child deaths). Thus, in 5 out of 9 of these cases a de facto partner was implicated. Case analysis shows that in none of these families did the childs natural parents co-habit. In almost half of the cases (n=4) the childs custodial parent had undergone a partnership change (in one case the resumption of a former relationship) in the recent months before the childs death, and in three of these cases the new partner was the perpetrator. Of the remaining cases, two involved de facto relationships where the length of the arrangement was unable to be discerned from case data, and three cases involved sole parents. Information relating to the number of referrals that were received about each child, the reasons for each notication and who made the notication are set out in table 2 below:

THE REPORTS TO THE NEW ZEALAND STATUTORY CHILD PROTECTION SERVICES

A total of 16 reports (referrals and notications) were received about the 9 children. Two children had 3 reports to child protection services prior to death, four had two reports, and in three cases there was only the one report before death occurred. Concerns about neglect, welfare and care arrangements dominated these reports. Physical abuse was cited in four of the nine cases. The dilemma for any child care and protection agency is how to rate the urgency of notications alleging neglect or expressing concerns about a childs living environment, alongside those of outright physical abuse. Understandably there will be a tendency to respond rst to the overtly physical episode. However, the fact that a number of these children were reported for concerns other than physical abuse but were subsequently physically harmed, highlights the importance of considering the particular vulnerabilities of children, and especially those of the younger child. The majority of the reports were made by sta of professional or helping agencies, with a lesser number being made by family members. That so many of the reports about these children were made by professionals is some validation of eorts to educate professionals about the signs and symptoms of abuse and of reporting pathways.

including care and protection interventions and statutory responses to requests for custody/access reports. Table 3 locates the homicides within these social work activities: Table 3: Incidence of child homicide across phases of CYF involvement
Phases of CYF involvement 1. Intake (closed, no further action required) 2. Investigation and assessment 3. Intervention solutions a. Family/Whanau Agreement b. Family Group Conference Plan (or Court-ordered plan following a FGC) 4. Alternative legal options (e.g. custody matters) Number of homicides 1 3 25 0

SUMMARY OF THE CASES

We will now provide a brief summary of each case, followed by a discussion of the issues raised from the case studies overall. 1. In one case, a notication was received, and workers assessed that there was no need for ongoing services and the intake was closed (no further action required). There was no investigation in this case. The school contacted statutory services when the child was distressed about going home with her caregiver. Following the initial information the social worker spoke to the child and the caregiver and the cause of the childs distress was explained as the changed arrangements for her to visit her mother. The social workers spoke again to the school and accepted their assurances about safety and monitoring. The referral was therefore closed. There were no further referrals of concern for this child who died three months later. 2. In three situations the homicide occurred during an investigation. a. In the rst of these cases two notications raised concerns about the mental health of a mother and the care of her small baby. Following the rst notication mental health

Table 2: Details of the 9 children known to New Zealand statutory child protection services
Child Referral/ Notication 1st: 29.11.96 2nd: 11.03.97 1st: 24.02.97 2 : 14.08.97
nd rd st

Reason for CPS involvement Neglect Court ordered custody/ access report Sexual abuse by father Sexual abuse by father Abduction Neglect Abuse/neglect Neglect Neglect Court ordered custody/ access report Physical abuse Court ordered custody/ access report Welfare Physical abuse Physical abuse Physical abuse/neglect

Referrer/ Notier Father Court Fathers ex partner Rape Crisis worker School Agency Member of public Agency Family friend Court Police Court School Health professional Health professional Agency

Perpetrator of child homicide Father

Date of death

Age at death

A Female

09.09.97

2.11 months

B Female

Father

10.09.97

12 years

3 : 10.9.97 C Male D Male E Female 1 : 13.08.97 2nd: 19.08.97 1st: 08.09.97 2nd: 26.01.98 13.08.98

De facto father De facto father Father De facto father

09.02.98 08.06.98 16.12.98

1.5 months 11 months 8 years

THE STATUTORY SOCIAL WORK PROCESS AND THE OCCURRENCE OF HOMICIDE

The study established a range of social work activities
3

F Male

1st: 19.07.96 2nd: 23.01.97 25.02.99 1 : 8.3.99

st

05.04.99

4 years

One child was in state care because of the injury that ultimately led to death. Prior to that injury, the child had had no contact with statutory child protection services. This child has therefore not been included in the qualitative analysis.
4

G Female H Male I Male

Mother & de facto partner (Female) Mother De facto father

10.05.99 20.08.99 12.01.00

6 years 8 months 4 years

We dene de facto parents as adults in a relationship with the biological parent, who are not themselves biologically related to the child.
5

2 : 13.8.99
nd

17.12.99

A Family/Whanau Agreement was proposed in one case but the child died before it was implemented.

32

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 3

33

social workers maintained the key role with respect to supporting the mother and the statutory child protection investigation was closed. Statutory social workers relied heavily on mental health professionals and lay people to provide the mother with support. A second notication was made when the child was in hospital. Four days later the case was allocated to a social worker and an initial investigation plan was developed. Varying information was received from medical professionals about the mothers presentation and care of the baby and the social worker made arrangements to visit the day following discharge. The social worker was unable to visit as arranged and the baby died two days later. The situation highlights the importance of working collaboratively across mental health/child protection boundaries and the need to ensure that information is claried to inform casework decisions. In the end the situation changed quickly and the child was le unsafe. b.The second case relates to a four year old child who was killed by his de facto father. The notication information was anonymous and the on- call aer hours social worker is recorded as having done a very good job at aempting to clarify the nature of the concerns. The notication was assessed as not requiring an immediate response, but was nevertheless followed up within the days immediately prior to Christmas. The social worker was unable to locate the family who were understood to have le the area for Christmas. A member of the childs extended family undertook to monitor the childrens wellbeing until their return in the New Year. The child was killed before further follow up occurred. c. The third child who died during an investigation was a twelve year old who was killed by her father following allegations of sexual abuse by him. The father admied to the police that he had been sexually abusing his daughter and was charged and released on bail with non-association conditions. Within two weeks of being charged with sexual abuse the father abducted her from school and she

died that day of multiple stab wounds. While the practice review indicated a number of general systemic issues occurring within the agency, they did not directly impact on the events of the case. 3. In two cases a Family/Whanau Agreement was determined as the level of intervention. A Family/ Whanau Agreement is an informal agreement that provides social work support and services for a family. a. In the rst of these cases, an agency reported concerns of neglect and wider family members expressed concerns about the welfare of three children in the family. Two older children were taken into care but the infant who subsequently died was le at home. The social worker consulted with the Care and Protection Resource Panel, convened a professionals case conference and held a family meeting at which a Family/Whanau Agreement was proposed and accepted. There was no formal risk assessment, however risk was assessed to be one of neglect and that a supportive casework response was indicated. Perhaps most signicantly the mother entered a new relationship, which was unknown to statutory services, and the child died within two weeks at the hands of the mothers de facto partner. The last social work contact was four weeks before the childs death. A report subsequent to the childs death indicated that the circumstances surrounding the death could not have been foreseen. b. In the second situation, there was one notication to statutory services about neglect and the failure to thrive of two young children. The investigation was inconclusive and when the mother and children moved to another part of the country the investigating social worker recommended to the new district a Family/Whanau Agreement, but also raised the possibility of a family group conference. The new district social worker visited once but did not sight the children. One of the children died subsequently at the hands of the mothers de facto partner. An investigation plan was developed but not formally recorded in the information system. No formal risk assessment

was undertaken and a greater focus on the childs needs may have strengthened practice with the family. Nevertheless the review commented that nothing they (the social workers) saw alerted them to the possibility of the tragedy that happened. There was nothing in the review that indicated the tragedy could have been foreseen or averted. 4. Three cases involved alternative legal options within the Family Court context a. In the rst of these cases, concerns about an infants living situation with her mother led to her being placed with her natural father (and his new partner). The mother identied the father as someone who could care for the children in the longer term. The social worker supported the fathers intention to seek guardianship and custody under alternative legal options. There did not appear to be an assessment of the fathers parenting capacity. He reported signicant management diculties with the child and requested information about parenting courses and counselling. The father did not want ongoing child welfare involvement and the case was closed when the father was granted interim custody, and assurances were obtained from a health professional about regular monitoring of the situation. The child died at the hands of her father two weeks aer case closure. b. In this case, the child was already subject to alternative legal care provisions and the court asked a statutory child protection social worker to report on a parent application to resume custody. The father, who was the custodial parent, had a history of mental health disorder and there were some indications that his condition was deteriorating. However, the father and child lived with the grandparents, a living arrangement that was considered a protective factor. The custodial parent killed the child on the evening of the day the court agreed to a change of custody to the other parent and before the custody transfer was possible. The social worker was seen to have acted professionally in this case.

c. In this nal case, the de facto partner of a preschool age childs mother, who had previously been imprisoned for an assault on the same child, killed the child. At the time of the rst assault, which led to the imprisonment of the perpetrator, social workers had encouraged the childs grandmother to seek custody and guardianship under private law provision on their assessment that she had the strength to prevent further contact between her daughter and her imprisoned de facto partner. The perpetrators likely internment was expected to be less than six months. Social workers withdrew from the case, assessing the child was safe. When released from prison on parole the de facto partner was ordered to live at the same address as the boys mother. A number of agencies were involved with the family. The child had had more than 40 separate contacts with a variety of medical professionals in the space of two or three years, many of which were injury related. There appeared to be lile coordination of information between services involved with the family. The child died two years aer the case was closed.

ISSUES RAISED FROM THE CASE STUDIES

The small number of cases considered here prevents us from generalizing any conclusions from the study. They do, nevertheless, promote areas of useful discussion that help to illuminate the tensions and issues inherent in child care and protection practice.

NEGLECTFUL PARENTING NOTIFICATIONS

Three of the nine children who died were referred for neglect as the predominant concern. Indeed, only three cases had physical abuse as the primary concern and one indicated concerns about sexual abuse. Situations of neglect are frequently responded to by a supportive casework response. In part this is because it is possible to monitor and respond to any deterioration within the family situation and to intervene if considered necessary. Given the history of the three cases and the fact that none had previous notications for physical abuse, the neglect assessment of risk and subsequent decision to provide support seems a reasonable service
35

34

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 3

response. Nevertheless, in all three the children experienced a violent death. Although the situations studied here indicate that a family support response was reasonable, children do die even though the presenting problem is one of neglect. Given these situations remain dicult to predict it suggests that the social worker antennae needs to remain alert to the possibility that other forms of abuse may occur. In the cases explored here - could the social workers have been more vigilant in terms of physical abuse risk? Could a formal risk assessment have alerted the social worker to the potential danger? Munro (2002, p. 85) argues the best guide to future behaviour is past behaviour. It could be argued that the absence of a history of abuse introduces the element of social work fortune telling when trying to predict future abuse. Herein rests a harsh but inevitable reality in terms of child protection practice: not all violence toward children can be predicted. Nor is it appropriate to treat all families who struggle to adequately care for their children as potential child killers. What is important is that we develop systems of response that are the best that they can be. And that these systems understand the dynamics of abuse, and the ways in which abuse and neglect dynamics interrelate.

high. Statutes are clearly delineated in their thinking about a childs protection needs and private law options through the Family Court are not primarily designed for responding to child protection requirements. The child protection provisions of the New Zealand legal scheme are specically designed to respond to issues of child protection and in this case would have been far more appropriate to deal with the level of risk within the family. The other two cases in which alternative legal options were adopted are not quite so clear cut. In the rst case (4 [a]) the father sought guardianship and custody under alternative legal provisions. Although there appeared to have been no assessment of caregiving capacity, there had been no previous concerns with respect to the father. While it was clear that he did not want ongoing child welfare involvement, he had described some signicant behavioural problems with his daughter and he was receptive to counseling support. Nevertheless, the degree of concern expressed about the daughters behaviour was such that an ongoing statutory oversight may well have been indicated. These are professional judgment calls that are based on what is considered reasonable at the time. In hindsight, once the tragic consequences are known, alternative responses can be readily perceived. Perhaps more important to remember in all this is the specic needs of the child. Social workers need to be childcentred and focus aention on the needs of the child in these challenging situations and not just the caregiver issues. The situation does reinforce the need to undertake a reasonably robust assessment of parenting ability and capacity particularly in the face of extreme child behavioural issues. The second situation (4[b]) involved a custody dispute in which the social worker was asked to report on a parent application to resume custody. A change of custody was decided by the court, but the child was killed by the custodial parent before the custody transfer could be made. Was the situation of sucient concern for the social worker to have warranted independent child protection action? The custodial parent did have a mental health disorder and there was some indication that the condition was deteriorating. But such situations are not exactly uncommon in custody disputes, and given

the lack of previous abuse history it is not clear that child protection action was indicated at that time. Importantly, the parent and child were living with grandparents a situation that was seen as a protective factor for the child. Research, however, indicates the potential dangers for children during changes in custody arrangements. Family disputes were found to lead to murder of children followed by the parents suicide in just over a third (35%) of child homicides in Australia between 1989 and 1999 (Lawrence, 2004). This highlights the importance of considering how custody decisions are enacted and whether there is a need for additional safety precautions for the child.

number of potential protective agents within the childs social and familial contexts. The FGC also provides the rst real opportunity for the family to work together to resolve the problems they face. Harnessing the strengths of the wider family group provides the opportunity to broaden the safety net for the child across the broader kinship system. In addition, a referral for a family group conference triggers a number of processes and activities, including increased professional involvement, and the development of family decisions and plans that can be formally monitored and reviewed.

CONCLUSION
Having looked at the nine children who died that were known to statutory child protection services it is clear that few were, in fact, predictable. As Ferguson (2004, p. 218) insightfully notes ultimately, we even have to be prepared to face the uncomfortable fact that any guarantees in protecting children are simply beyond the capacities of what human beings are capable of, even trained professional ones. Child protection practice is complex and despite the relentless search for professional error when a child dies, it is important to understand that interventions can fail for a variety of reasons. Families may be uncooperative and evasive in their responses to professional interventions. For some vulnerable people the capacity to form and maintain healthy relationships with their children and, indeed, with those professionals seeking to protect them, ultimately may undermine protective action by others (Ferguson, 2004). Reviewing child deaths in the context of statutory child protection services can create a culture of blame and precipitate reactive responses that do lile to promote practice improvements. Alternatively, they can provide us with important practice insights that can foster positive practice change. The challenge for child welfare systems is to create environments within which they have the capacity to do the laer.

UNDERSTANDING RELATIONSHIPS WITHIN THE FAMILY

In a signicant number of the cases explored in this study there were important issues relating the childs relationship with the caregiver. Overwhelmingly the cases reected dynamics in the caregiver/child relationship that ultimately created dangers for the child. A number of the children were killed by their de facto parent. While being step-parented is identied in the literature as a risk factor, within this small study the issue was more to do with the quality of the relationship between the caregiver and the child than the step-parenting relationship per se. Poor aachment bonds were common with this group overall and the de facto parents aitude to the child was either emotionally ambivalent, or hostile. The quality of the relationship between the biological parent and the child was also an issue reecting complex relationship dynamics. Two of the parents had a very intense and enmeshed relationship with their child (one involved sexual abuse) and two others had recently become primary caregiver. Again, the quality and nature of the relationship between parent and child is critical to the understanding of the potential danger.

ALTERNATIVE LEGAL OPTIONS AND CHILD HOMICIDE

In three of the cases the children were involved in private law Family Court proceedings prior to their death. The three cases present us with a range of dierent circumstances. In the last family situation (4 [c]) the family history and level of risk indicated by previous violence raises signicant questions regarding the lack of decisive child protection responses. In the space of two or three years the child had had more than 40 separate contacts with professionals presenting with suspicious injuries. His stepfather, who had previously been imprisoned for abusing him, was expected to be released in a relatively short period of time. The childs safety was reliant on the strength of a grandparent in the face of an abusive, aggressive male who had been imprisoned for violence related crime. It is reasonably clear that the circumstances surrounding the situation were serious and that the level of risk

STATUTORY INTERVENTIONS
Although the sample is very small, it is interesting that no child died of non-accidental injury following the holding of a family group conference. Family group conferences have the eect of increasing the

36

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 3

37

ARTICLE
REFERENCES
Berridge, D. & Cleaver, H. (1987) Foster Home Breakdown. Oxford, Blackwell. Connolly, M. (2006) Practice frameworks: Conceptual maps to guide interventions in child welfare. British Journal of Social Work. Advanced Access published June 16, 2006. doi:10.1093/bjsw/bcl049. Connolly, M. & Doolan, M. (in press). Lives cut short: Child homicide research and response. Christchurch, Te Awatea Press. DHSS. (1985) Social Work Decisions in Child Care. Department of Health and Social Security, London, HMSO. Ferguson, H. (2004). Protecting children in time: child abuse, child protection and the consequences of modernity. New York: Palgrave. Kinley, L. & Doolan, M. (1997) Paerns and Reections: Mehemea. Wellington, N.Z., Children, Young Persons and their Families Service. Lawrence, R. (2004) Understanding fatal assault of children: A typology and explanatory theory. Children and Youth Services Review, 26, 837-852. Mansell, J. (2006) The underlying instability in statutory child protection: Understanding the system dynamics driving risk assurance levels. Social Policy Journal of New Zealand, 28, 97-132. Munro, E. (2002) Eective child protection. London: Sage. Munro, E. (2005) Improving practice: Child protection as a systems problem. Children and Youth Services Review. 27, 375-391. Packman, J., Randall, J., & Jacques, N. (1986) Who needs care? Oxford: Blackwell. Sco, D. (2006) Sewing the seeds of innovation in child protection, keynote presentation to the 10th Australasian Conference on Child Abuse and Neglect, Wellington. Stake, R. (1995) The Art of Case Study. London: Sage Publications Inc. Triseliotis, J. (1989) Foster Care outcomes: A review of key research ndings. Adoption and Fostering, 13, 5-17. 38 Communities, Families and Children Australia, Volume 2, Number 1, April 2006 Authors Dr. Maria Harries Associate Professor Discipline of Social Work & Social Policy University of Western Australia. Dr Bob Lonne Senior Lecturer School of Social Work & Applied Human Sciences University of Queensland Dr. Jane Thomson Senior Lecturer & Head of School School of Social Work & Community Welfare James Cook University. Address for Correspondence Dr Maria Harries AM PhD Associate Professor Discipline of Social Work & Social Policy School of Social & Cultural Studies University of Western Australia M256 35 Stirling Highway, Crawley, WA 6009 Phone: +61 8 6488 2993 Fax: +61 8 6488 1070 Email: mharries@cyllene.uwa.edu.au

Protecting Children and Caring for Families: Re-thinking Ethics for Practice
Maria Harries PhD, Bob Lonne PhD and Jane Thomson PhD

ABSTRACT
In this paper we argue that contemporary risk averse child welfare practice is at risk of relegating decision making to a singular orientation, viz., to a deontological approach, dominated by the highly seductive and indeterminate rights-based best interests principle. It thereby risks consigning other ethical principles to subsidiary positions or disregarding them completely. We posit that a preoccupation with a single principle precludes aention to the wider political context and structural disadvantage, fails to analyse broader outcomes, and is having a deleterious overall eect on children and families. In its place, we present a theoretical model for contemporary ethical decision making in child welfare practice based on recognition of three crucial conceptual elements: competing ethical principles, unequal power relationships and complex stakeholder responsibilities. Finally, while explaining the models relevance and applicability, we acknowledge tensions for workers in the hot environment in which being seen to follow rules and protect the best interests of the child are seen as political priorities. Any risk of not following procedure is a preoccupying anxiety for workers and their agencies, given the present context in which time and resource constraints and fear dominate practice.

INTRODUCTION
In re-thinking ethics when working with children and families, our approach has been informed by a number of experiences and people. Some of these have become the threads in a kind of rich tapestry weaving together years of accumulated experience of working with children and families in distress, and related research. Other inuences are easier to aribute and are more contemporary. Among the laer are the voices of three particular people whose observations have either propelled our thinking or resonate with it. The rst is a child protection worker, who in 2005 said at a focus group aimed at developing a framework for services aimed at chid and family wellbeing: My only concern as a child protection worker is the one principle what

Research article 4

39

is in the best interests of these children? I would love to but cant aord to be concerned with the welfare of this mother besides, its my bu that gets kicked if I give her the benet of the doubt. The second is a comment by Thomson and Thorpe (2004), on the experience of parents whose children had been removed from their care: Parents in the group identied the positive eect of experiencing respect and support from group workers and members in contrast to the judgment, condemnation and lack of respect that they experienced in their interactions with some child protection workers (Thomson & Thorpe 2004:51) The third an observation made by Dorothy Sco at a recent conference in New Zealand: Our current child protection systems are unsustainable and harmful to children and their families. We are at the crossroads in the history of child protection (Scott 2006:1).. The rst two statements tell us something about the principal ideas and factors that may be informing child welfare decision making particularly the centrality of risk and how their application is experienced by the various stakeholders: the last one gives us a grim view about some possible outcomes of our contemporary decision making. Even though they may be considered idiosyncratic, all three observations provide an impetus to reection and should give us reason to at least question how wisely or otherwise we are managing our decision making in the name of protecting children. Given that all decision making in social care is fundamentally concerned with ethical issues, (Thompson, Melia & Boyd 2000), these statements give us a very practical lead into a re-examination of ethics in current child welfare practice. Three other comments need to be made about the quotations above in relation to practice: the rst is to note the salience of risk, not to the child but to the worker; the second is the central importance of respect and relationship (for clients and workers); and thirdly, how we utilise our knowledge about the outcomes of what we do in order to improve the

benets to all involved. All of these maers are highly relevant to a re-engagement with the fundamentals of ethics for practice in child welfare. In this paper we undertake a critical analysis of the systemic structures and ethical assumptions inuencing State directed child protection interventions into family life, and the processes which fundamentally inuence the relationships and outcomes for the individual stakeholders. At issue are current societal and organisational discourses and approaches to ensuring the safety of vulnerable children, rather than the actions of particular individuals who we would argue have a limited agency within the system.

ETHICS FOR PRACTICE:

Essentially ethics can be pared down to the study of the standards by which we make decisions about the best things to do in circumstances in which we nd ourselves. In traditional professional codes and practice there appears to be an assumption that ethics is simple and static and that all one has to do is simply apply moral principles to problems. Ethical discourse is not static, nor is decision-making simple. Ethical practice oen requires us to make tough decisions in arenas that are fraught with diculties and in which emotions and dierences abound. The choice is oen not between what is right or wrong but rather what is best or worst in the situation. There are numerous tomes on ethics and ethical practice for all professionals including social workers. In this paper we take an Aristotelian view of ethics which sees ethics as being about how we work together to grow communities that ourish. Within this view, ethical practice is not about private morality and blind obedience to rules on tablets of stone but rather it is about how we engage together in work that contributes to the development of a 'good' rather than a dysfunctional community. It is not just about what we do - it is about how we do it. Furthermore, it is not just about what we do with clients but how we understand the societal mandate for what we do and how we do it with each other. Ethical practice is more than the application of ethical principles (Thompson et al 2000). Ethics is

concerned with the conditions for the ourishing of human societies, with power sharing and avoidance if possible of causing more harm than good. Practising ethically involves sharing with others in problem-solving activities based on knowledge of principles and skills in their application. For child welfare practitioners, practising ethically does involve working with universal principles, but more importantly, how these are to be applied to intensely personal and private issues and the rights of all stakeholders within a highly contentious, contested and culturally diverse public environment. This requires working in partnership with other stakeholders which makes practitioners feel very responsible and vulnerable, and where bad outcomes generate much feared media aacks. There are a number of ways of capturing the diverse history of ethics and moral theory. The simplest is one that is described well by Thompson et al (2000) who distinguish between three primary ways of thinking about ethics: Deontological views are based on what are assumed to be self-evident rst principles and are built on a belief that there are categorical imperatives, namely, ways to work out the right thing to do by resort to obligatory moral positions e.g. always tell the truth. Some deontologists would argue that all ethical decision making is determined by a set of rules which dene our duties and rights. Doing our duty might mean in this context always giving priority to the rights of the child, or always acting in the best interests of the child. Ethical decision making here simply means trying to answer the question, what rules should I follow? From this point of view the consequences of an action are irrelevant to whether it is the right/wrong thing to do. Teleological views are based on assessments of outcomes, that is, striving to achieve the best thing in the circumstances, by choosing to do what we believe will produce the best outcomes. Decisions are made on the basis either of what actions will cause the least pain or bring the most benet to individuals (act utilitarianism) or what policy will result in the greatest good for the greatest number (rule utilitarianism). In both cases the way to work out the right thing to do or the right policy

is to work out which is likely to have the most benecial consequences. A teleological position is not necessarily synonymous with pragmatism. The decisions here are based on the question, what short- or long-term ends should I pursue? From this point of view it is not clear by what criteria we are to assess costs and benets of actions or policies. Virtue ethics emphasizes the cultivation of the virtues, or the moral character of the decision maker, as a necessary condition for sound ethical decisionmaking. Virtue ethics stands in contrast to the approach which emphasizes our duty to obey rules, or which makes the consequences of actions the touchstone of morality. In virtue ethics competent decisions are based on a mixture of knowledge and skilled judgment or practical wisdom. This must be informed by real experience, and not just abstract principles or anticipation of future consequences. What virtue ethics emphasizes is that the quality of the decision and action is mediated by the integrity, practical wisdom and competence of the decision maker. What is needed in order to apply principles correctly is the ability to understand the context, articulate the important elements and to anticipate outcomes (MacIntyre 1982). What Macintyre (1982) encourages us to do is to re-visit the foundational work of philosophers such as Aristotle who argued that good decision making and personal integrity are linked to wisdom the acquisition of moral competence based on excellence in judgment and the ability to integrate our knowledge and experience. It cannot be just the blind following or application of rules. A deontologist may point to the fact that they will be acting in accordance with a moral rule such as do unto others as you would have them do unto you; a teleologist to the fact that they hope the consequences of doing something will maximise well-being; and a virtue ethicist may argue that helping someone is a good or benevolent act in its own right. The philosopher Niebuhr (1963) argues that our actions are not so easily categorised, that is, they are neither simply rule governed nor simply aimed at achieving idealistic goals but are a bit of both - they are aimed at acting responsibly and responsively in relationships of tension. Tobin, a contemporary writer about virtue ethics, captures the nexus between approaches and
41

40

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 4

the subsequent complexity in this way: Ethics is about doing the right thing and - more importantly - about being the kind of person who can be relied upon to do the right thing (Tobin 1994: 55). In a virtue ethics framework, the practitioner provides the bridge between principles and outcomes - what virtue ethics emphasises is that the quality of the action produced is aected by the integrity and competence of the moral agent (Thompson 2000: 303). There has been a signicant development in recent years in conceptualising ethics for professional practice (Banks 2006; Weber 2006; Hugman 2005) and a growth in interest in the ethic of care for practice in the caring professions which dates from the seminal work of Gilligan (1982). This literature and these developments are important to note and will be usefully the subject of more analysis in coming papers. However, arguably, practitioner understanding of ethics continues to be dominated by professional codes of ethics or codes of conduct, and the way principles are uncritically presented in these. In contrast, by re-introducing virtue ethics to our repertoire of understanding about ethics we may rediscover that action-guiding rules cannot be applied reliably or correctly without practical wisdom, because correct application requires situational appreciation. That is, we need to develop the capacity to recognise, in any particular situation, those features of it that are morally salient and those people whose welfare will be aected by any decision we take. This means that sound ethical practice is about contextualised decision making rather than policies that dictate a one size ts all approach (Barton & Welbourne 2005). The relevance of all of this to child welfare decision making must be prey obvious. What dierent principles are relevant to the decision making process when the wellbeing and futures of both children and families are at stake? How are these principles factored into our decision making when we consider all of the relevant stakeholders? What do we really know of the outcomes of dierent child welfare practices and who benets and loses? How sound is the evidence base for our practice? What do children, young people and families themselves have to say about the decision making processes they have experienced? How do we facilitate the learning of
42

practitioners to help them develop practical wisdom and competence rather than simply follow rules (or even standard procedures) in their decisions? Professional codes of ethics can only give practitioners a range of core ethical principles to guide practice and by which to manage their decision making. Most current legislation and departmental policies include large sections on core principles that should underpin decision making. Yet, the examples quoted at the start of this paper give some insight into the limitations of this approach and argue the case for a more realistic approach to decision making, that takes account of the complexity of the processes involved and the dicult situations we have to address. Hogdkin & Newell (1998) maintain that the best interest of the child forms the core principle in child welfare and dominates practice internationally. If this is the guiding principle, what does it mean to workers and how is it to be explained to parents and families? What behaviours does it demand? It appears to be a principle but in reality, it assumes a known outcome. In reality it directs actions and decisions toward an unspecied end point where supposedly the interests of the child will be clearly realised. If it is an outcome, what means or predictions are used to justify it? Without utilising a virtue ethics framework, how does anyone assess how such an outcome is benecial or harmful? How valid are such predictions unless they incorporate a longterm view of the vagaries of a childs development into an adult? In reality, decision making has to be undertaken in the here and now with contemporary issues and risk assessments predominating, rather than embracing longer term perspectives? It is not possible to respond to all of these questions here: some of them need extensive review but others will be addressed in the framework below. First, there is a need to locate ethical debate and decision-making in the context of the contemporary environment within which child welfare is practiced. In our view, much contemporary child protection decision making is fundamentally awed by its focus on managing immediate risks and risk avoidance, as the fundamental imperatives. These are rhetorically justied by appeal to the best interests of the child

and tend to be based on ignorance of longer term impacts on the wellbeing of children and their location within their families and communities.

THE SOCIAL AND MANAGERIAL CONTEXT FOR ETHICAL PRACTICE

Much has been wrien about the fact that professionals working with children and families in adversity, whilst aiming to protect children from signicant harm, are working in environments that are increasingly risk focused, ambiguous, demanding and demoralising (Parton 2005, Lawrence 2004, Howe 1992). Working in neo-liberal political environments with limited resources at their disposal, and where demands for economic constraint, reduced taxes and government expenditure drive social policy workers have to deal with some of the most marginalised and disadvantaged people in our communities. Practitioners are being asked to safeguard children and balance the rights of families and communities at the same time as having to cope with a sensationalist press ever ready to point an accusing nger at them or at the families they meet (who are seen to have failed as parents). In these circumstances professional accountability is akin to accepting blame and retribution. It is also apparent that many workers are not ethically trained or equipped with the skills to deal with the new organisational priorities and mechanisms within which they have to work (Lonne, McDonald & Fox 2004). Perhaps it is not surprising that it is a worldwide phenomenon that front line workers in child welfare are increasingly hard to recruit, resign quickly and burnout at a rapid rate (Lilechild 2005; Bednar 2003; Stanley & Goddard 2002; Stevens & Higgins 2002). Rabbi Neuberger, oers a powerful critique of the way we manage vulnerability in our society, and asks whether the present care system works to anyones benet. She argues strongly for a return to a dierent [respectful] aitude towards social workers and front line workers (Neuberger 2005:191): At present we have a risk averse society, more concerned with stopping one child murder

however awful than with supporting dozens if not hundreds of vulnerable youngsters via a system that places full trust in the judgement of professionals (Neuberger 2005: 126). {Comment: This is a view powerfully
supported by Onora ONeill}

If Neuberger is right and our communities and press have lost faith in the judgment of child welfare workers, then it is necessary if their judgment is to be trusted again, that professionals are able to articulate the moral principles on which their judgments are made (deontological), subject these to rigorous scrutiny in terms of their assessed outcomes (teleological) and embrace the challenges of becoming competent moral agents who dont simply follow procedures but apply these with prudence (virtue). Professionals need to feel safe. They need to be protected from the threat of becoming victims of moral panics themselves (Jenkins 1998), or objects of criticism in a culture of blame (Reder, Duncan & Gray 1993; MacDonald 1990) or driven by the riskaversive policies of politicians (Parton, Thorpe & Waam 1997, Kemshall 2003). Paradoxically, given the contemporary managerial preoccupation with procedures, rationing and rules, the existing environment which Neuberger describes, does not assist towards greater transparency or a reawakening of the values necessary for enlightened ethical practice. Instead it relies on procedures, regulations and a narrow pursuit of professional survival. It is in this risk averse environment and within the current conditions of profound uncertainty that Webb asserts we need to relocate a model of practice that is ethically valid as well as functionally accountable one that re-awakens our commitment to the most vulnerable populations in contemporary society (Webb 2006: 1).

THEORETICAL FRAMEWORK
In this paper we are arguing that we need to re-visit the ethical foundations of our work in child welfare. In addition to recognising the imperative of having to adopt a new ethical stance in our predominantly neo-liberal communities, there are three conceptual elements which, we argue, form the crux of good ethical decision making. These elements might
43

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 4

enable us to meet the challenges named by researchers, commentators and scholars, reported by practitioners, and echoed by young people and families who are caught up in the web of child welfare practice today. We have called these three conceptual elements: competing ethical principles, unequal power relationships and complex stakeholder responsibilities. (i) Competing Ethical Principles The three competing ethical principles that are central to all decision making, and are always in tension in any given society, are benecence, justice and respect for persons (Thompson et al 2000). These principles feature in some of the earliest known codes of ethics and law, and have served as a foundation for the development of modern bio-medical and social ethics. Benecence (oen referred to as the duty of care) constitutes the duty to do good rather than harm, to protect the weak and to defend the rights of those who cant defend their own. Justice represents the duty to treat people as ends in themselves and never as means to an end, to be fair and equitable to all and to avoid discrimination. Respect for persons contains the duty to value the rights, autonomy and dignity of all people and in so doing to be truthful and honest with them because in doing otherwise, one is not respecting them. Duty of care sits easily with an understanding of childhood and vulnerability. No sensible person would suggest that adults dont have a duty to care for and protect children. We have already suggested that in the current risk averse and managerially dominated environment, the prime activity associated with the duty of care to children relates to the assessment of or prediction of risk and likelihood of harm. This carries the accompanying duty to protect any child from harm. In reality this is oen a highly speculative endeavour where, unless great aention is paid to the context and relationships, imponderables and subjective values determine our understanding of duty and drive us to impute certainty to our knowledge of outcomes. Prediction of risk is by every denition, a most inexact science! Yet it has won almost universal favour as the guiding criterion for determining duty of care for children and for allocating resources. As Kemshall (2002)

indicates, risk has replaced need as a determinant of the duty to provide a service. Justice and respect are two principles that can and must be held in tension with the duty of care, in all ethical decision making processes and certainly when one is considering the wellbeing of children. Yet, we argue, these other principles are oen overlooked as the preoccupation of statutory workers and the legal advisory system coalesce and potentially collude around the best interests of the child. Barbara Hudson argues that justice is under threat in the risk society (2003: 203). Those who are seen to be the source of the risk are considered less worthy and they become of themselves, bad, less worthy or dangerous. And, in considering risks to children, in our risk-averse society the individuals who are held primarily responsible are the natural parents. Indeed, as Urek (2005) and others argue, it is the bad mother who is primarily named and shamed. A preoccupation with the procedures of risk assessment threatens to ignore issues of justice (non discrimination) and it also threatens the duty we have in a moral community to respect or value the humanity and dignity of all other stakeholders (rather than just the child). In this instance, the main threat to the integrity of the ethical decision making process is that of excluding the fundamental respect that is owed to parents: human beings who are themselves in trouble (Senne 2003). ii) Power All relationships mediate power. Indeed, ethics is about power in relationships and the basis of power-sharing between them (Thompson et al 2000). Professionals working in child welfare, typically work with people who have lile power (Thorpe 1994) and yet they are in the situation where they have access to much power themselves. At the very least, professionals have positional, reward, coercive and expert power. When parents meet with professionals they confront formal statutory power (people employed by the state to carry out its duties), coercive power (people who can take their children away), expert power (people who are expected to have a scientic knowledge base). It should not surprise any of us that, in his recent research with parents, Dumbrill found that the way

parents perceive workers using power was shown to be the primary inuence shaping their views and responses to child protection intervention (Dumbrill 2006: 27). People who are reported for abusing their children by and large come from communities with lile structural power. They are generally poor, from Indigenous or culturally and linguistically diverse communities, are single parents or have a mental health, intellectual, addiction or other health problem. And their access to nancial, legal or personal resources is severely constrained. McConnell and Llewellyn state this concern forcefully: children removed by child protection authorities typically come from poor and marginalised families and the cruel and uncaring parent mythologised in the media is rarely encountered in child protection practice (2005: 554). Indeed, one has to wonder whether the widespread demonising of abusive and neglecting parents has been carried out with the political purpose of justifying the signicant powers given to child protection authorities on behalf of the State. McConnell and Llewellyn (2006) argue that in not recognising their own power and the inherent powerlessness of these families, professional practice is subscribing to the de-politicisation of social inequality. There is of course, the counter argument to this and that is that the child is even more vulnerable than either or both relatively powerless parents or carers and that it is our duty to protect the most powerless person the child (Tew 2006). Within this laer argument there sits the assumption that there is a need for a forced either/or choice rather than a need to acknowledge the mobility of power and the indeterminacy of power dierentials between various stakeholders. In his very recent publication, Tew presents an excellent multidimensional matrix of power (protective, co-operative, oppressive or collusive) that he says enables workers to pay aention to the dierent ways that they can use the power they have and helps them to acknowledge the relative powerlessness of the various clients they meet. For the purposes of this paper, Tews is a timely construction of power, for in his words, it is one that does not have an inherent tendency to put down the service user and dene them as someone

who is essentially inadequate, needy or dangerous (2006: 48). iii) Complex stakeholder relationships Ethical decision making in child welfare, like all decision making demands a process in which competing duties to various stakeholders need to be factored into the analysis without jeopardising the practitioners primary duty to a vulnerable child. Yet, in conceptualising ethical decision making in child welfare, one could be forgiven for believing that, as Sco and ONeil (1996) have critically observed, child protection practice tends to simply apply the principle of duty of care in the dyadic relationship between abused children and the professionals who rescue them. In this model, the child is seen as being in need of protection by the worker (who has a duty to protect him/her). Where a child has been intentionally and seriously harmed by an adult, no one would deny that there is an immediate and absolute duty to remove and protect that child. However, while there has been a longstanding emphasis on the importance of family, when child welfare concerns are being mediated, it is only more recently that the complexity of these and other stakeholder relationships have become pronounced in child welfare decision making. These stakeholders have been referred to by some as the unheard clients (Dale 2004; Kapp & Vella 2004). It is evident that there are indeed multiple stakeholders involved in most child welfare decisions. First, it is impossible to understand the work of child welfare professionals without taking account of the ethical duties workers have as dened by the procedures of their employing authority. Secondly there are the pressures they experience in relation to media monitoring of their work. Fourthly, we cannot ignore the views of those who have experienced child protection investigation or the care system (Senate Commiee Report 2005). Fihly, it is increasingly clear that the other stakeholders in this journey siblings, foster parents, grandparents, communities and professionals also want and expect their concerns and needs to be heard. As a consequence, all professionals working in child welfare are becoming aware that they may be required to conceptualise and articulate the decision

44

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 4

45

making task more comprehensively and to recognise its complexity. Here we might heed the advice of Nietzsche: Beware of the dreadful simpliers. It is our argument that this requirement for acknowledging complexity has always been present, although simplistic deontological approaches have underrated its importance. Additionally it should be emphasised that we have a responsibility to apply the three ethical principles of benecence, justice and respect for persons to all major stakeholders involved in the lives of each child recognising that decisions will have to be made about what priority is given to which principle in each case. Furthermore, decision making processes should also embrace a critical analysis of the contextual variables present in each specic case, along with generalised legislative requirements and organisational policies. Furthermore, assessment of the risk of harm should specically entail examination of the longer term outcomes as well as the immediate and pressing issues of safety.

the vagaries of real life, under conditions of uncertainty, where they have limited resources, face overwhelming proceduralisation and confront the relentless risk of judgement by management and media. Re-framing ethical decision making in child welfare within a virtue ethics framework offers us an important opportunity to deal with these factors more realistically. Virtue based and prudential ethical decision-making requires us to consider and balance different principles, respect the rights of multiple stakeholders, understand the demands of the specic context, face the uncertainty of judgements about immediate and longer term outcomes, and face the challenge to become professionals of integrity who not only do the right thing but are the sort of people who do the right thing. With the new organisational imperatives associated with increasing risk aversion in public life and public policy, and media alarmism, both creating increased pressures to interventionist policies in child welfare practice (Parton 2005), there is an even more urgent need to retain and build value-based judgements that care for children in an atmosphere of genuine respect and partnership with families and communities. It is important to re-build trust in the decision making competence of child welfare practitioners. Finally, we must re-engage with the justice imperative that in society, and particularly in the welfare state, the nub of the problem we face is how the strong practice respect towards those destined to remain weak (Sennett 2003: 263).

Climates in Child Welfare Agencies, Families in Society, 84(1), 7-12. Buckley, H. (2003) Child Protection Work: Beyond the Rhetoric, Jessica Kingsley Publishers, London. Dale, P. (2004) Like a Fish in a Bowl: Parents Perceptions of Child Protection Services, Child Abuse Review, 13, 137-157. Davies, L. (2004) Monsters and heroes: Constructions of Clienthood: a postcolonial discourse. PhD thesis, University of Western Australia. Dumbrill, G. (2006) Parental experience of child protection intervention: A qualitative study, Child Abuse & Neglect, 30(1), 27-37. Frensch K. & Cameron, G. (2003) Bridging or Maintaining Distance: A Matched Comparison of Parent and Service Provider Realities (Summary), www.wlu.ca/pcfproject Freymond, N. (2003) Mothers Everyday Realities and Child Placement Experiences, Partnerships for Children and Families Project, www.wlu.ca/ pcfproject Gardner, H. (1998) The Concept of Family: Perceptions of Adults who were in long-term out of home care as children. Child Welfare, 77(6), 681-700.

foster care, Child and Family Social Work, 9, 197-206. Kemshall, H. (2002) Risk, social policy and welfare, Open University Press, Buckingham. Lawrence, A. (2004) Principles of Child Protection: Management and Practice, Open University Press, Berkshire, England. Lilechild, B. (2005) The Nature and Eects of Violence against Child Protection Social Workers: Providing Eective Support, British Journal of Social Work, 35, 387-401. Lonne, B., McDonald, C. & Fox, T. (2004) Ethical Practice in the Contemporary Human Services, Journal of Social Work, 4(3) 345-367. MacDonald, G. (1990) Allocating Blame in Social Work, British Journal of Social Work, 20, 545-546. MacIntyre, A. (1982) Aer Virtue: A Study in Moral Theory, Duckworth, London.

IMPLICATIONS FOR CHILD WELFARE PRACTICE

There is a vast amount of evidence which tells us that those who are investigating child protection complaints are primarily investigating children and families who are marginalised by factors such as: illness, poverty, disability, single parenthood and ethnic minority status (McConnell & Llewellyn 2005; Thorpe 1994). Yet the dominant child protection assessment model is one focused on determining whether a parent (generally the mother) is suitable (Urek 2005; Sinclair 2000) and whether a child or children are at risk from parents (generally the mother). Contemporary child protection practice will remain bedevilled by the demonstrable shortcomings of a predominantly linear and limited deontological ethical decision-making framework, which fails to take into account the context of power relations and their complexity. We must face the challenge to develop a strong value base in which a duty to protect children is balanced with the principle of respect for all people involved and where the principle of justice is permitted to nd a place back at the decision making table. Professionals in child welfare have a tough job making decisions about the welfare of children that recognises
46

McConnell, D. & Llewellyn, G. (2005) Social inequality, the deviant parent and child protection practice. Australian Journal of Social Issues, 40(4), 553-566.
Niebuhr, H. (1963) The Responsible Self: An Essay in Christian Moral Philosophy, New York, Harper & Row. Neuberger, J. (2005) The Moral State Were In: A Manifesto for 21st Century Society, Harper Collins Publishers, London. Parton, N. (2005) Safeguarding Children: Early Intervention and Surveillance in a Late Modern Society, Palgrave, Macmillan, London. Parton, N., Thorpe, D. & Waam, C. (1997) Child Protection: Risk and the Moral Order, Macmillan, Basingstoke. Reder, P, Duncan, S. & Gray, M. (1993) Beyond Blame: Child Abuse Tragedies Revisited, Routledge, London. Sco, D. (2006) Sowing the Seeds of Innovation in Child Protection, 10th Australasian Child Abuse and Neglect Conference, Wellington, New Zealand, February. Sco, D. & ONeil, D. (1996) Beyond Child Rescue, Allen & Unwin, Australia.

Gilligan, C. (1982) In a Different Voice: psychological theory and womens development, Harvard University Press,
Cambridge, Mass. Hodgkin, R. & Newell, P. (1998) Implementation Handbook for the Convention on the Rights of the Child, New York, Geneva, UNICEF. Howe, D. (1992) Child abuse and the bureaucratisation of social work, The Sociological Review, 14(3), 513532. Hugman, R. (2005)

REFERENCES
Australia. Parliament. Senate. Community Aairs Reference Commiee. (2005) Protecting vulnerable children: A national challenge, Second Report on the inquiry into children in institutional care. The Senate, Canberra. Banks, S. (2006) Ethics and Values in Social Work, (3rd ed.) Palgrave, London. Barth, R. (1990) On Their Own: The Experiences of Youth aer Foster Care, Child and Adolescent Social Work, 7(5), 419-440. Barton, A. & Welbourne, P. (2005) Context and its Signicance in Identifying What Works in Child Protection, Child Abuse Review, 14, 177-194. Bednar, S. (2003) Elements of Satisfying Organisational

New Approaches in Ethics for the Caring Professions, Palgrave

Macmillan, London. Jenkins, P. (1998) Moral Panic: Changing Concepts of the Child Molester in Modern America, Yale University Press, New Haven. Kapp, S. & Vella, R. (2004) The unheard client: Assessing the satisfaction of parents of children in

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 4

47

ARTICLE
Senne, R. (2003) Respect: The Formation of Character in an Age of Inequality, Penguin Books, London. Sinclair, T. (2005) Mad, bad or sad? Ideology, distorted communication and child abuse prevention, Journal of Sociology, 41(3), 227-246. Sinclair, T. (2000) Destructive Discourses: Child Protection and Systematically Distorted Communication, Sociological Sites/Sights, TASA Conference, Adelaide, Flinders University. Smith, D. (2005) Values and Practices in Childrens Services, Palgrave Macmillan, Hampshire. Stalker, K. (2003) Managing Risk and Uncertainty in Social Work: A Literature Review, Journal of Social Work, 3(2), 211-233. Stanley, J. & Goddard, C. (2002) In the Firing Line: Violence and Power in Child Protection Work, John Wiley & Sons, Chichester. Stevens, M. & Higgins, D. (2002) The Inuence of Risk and Protective Factors on Burnout Experienced by those who work with Maltreated Children, Child Abuse Review, 11, 313-331. Tew, J. (2006) Understanding Power and Powerlessness: Towards a Framework for Emancipatory Practice in Social Work, Journal of Social Work, 6(1), 33-51. Thomson, J & Thorpe, R (2004) Powerful partnerships in social work: group work with parents of children in care, Australian Social Work, 57(1) 46-56. Thompson, I., Melia, K, & Boyd, K. (2000) (4th ed.) Nursing Ethics, Churchill Livingstone, Edinburgh. Thorpe, D (1994) Evaluating Child Protection, Milton Keynes, Open University Press. Tobin, B. (1994) Codes of Ethics: Why we also need practical wisdom, Australian Psychiatry, 2(2) 55-57. Urek, M. (2005) Making a Case in Social Work: The Construction of an Unsuitable Mother, Qualitative Social Work, 4(4), 451-467. Webb, S (2006) Social Work in a Risk Society: social and political perspectives, Palgrave Macmillan, Hampshire. Weber, Z (2006) Professional Values and Ethical Practice, in A. OHara & Z. Weber (Eds.) Skills Paul Wyles Director, Client and Adolescent Services Ofce for Children, Youth and Family Support ACT Department of Disability, Housing and Community Services GPO Box 158 Canberra ACT 2601 Phone: +61 2 62050598/ +61 409 772343 Fax: +61 2 62078888 Email: Paul.wyles@act.gov.au for Human Service Practice, Melbourne, Oxford University Press. Westco, H. & Davies, G. (1996) Sexually Abused Childrens and Young Peoples Perspectives on Investigative Interviews, British Journal of Social Work, 26, 451-474.

When the bough breaks the cradle will fall

Child Protection and Supervision: Lessons from three recent reviews into the state of child protection in Australia
Paul Wyles
It has become almost inevitable that on an annual basis there is a review into child protection in an Australian state or territory. These reviews result in common recommendations about service improvements, increased resourcing, structural reorganisation and legislative reform. Within this context, this article explores what three recent child protection reviews in the ACT, Queensland and South Australia have to say about supervision. The paper argues that without a focus on sta supervision in child protection there is unlikely to be signicant improvement to service delivery for the most vulnerable children and families in our community.

INTRODUCTION
Acknowledgements: Thanks to Dr Morag McArthur and Dr Gail Winkworth of the Institute of Child Protection Studies at the Australian Catholic University for their work in providing useful comments on the development of this paper. In her foreword to the South Australian Report Our Best Investment, A State Plan to Protect and Advance the Interests of Children, Robyn Layton identies the provision of an overall framework for child protection as the prime purpose of her review. She uses the metaphor of a tree: It [my purpose] was to draw the tree with the trunk and the branches so that the leaves could later be discussed and drawn in by others (Layton, 2003). Along with improved legislation, resourcing, professional development and placement options, professional supervision is the key element, branch or bough supporting the child protection system. This paper focuses on supervision and argues how critical it is to growing improved child protection services and child protection systems in Australia. Further, without a focus on improving supervision for child protection workers the system will continue to struggle with inexperienced sta, high sta turnover and poor decision making. The paper provides a brief overview of the common and accepted understandings of the concept of supervision. It presents an analysis of the recommendations of three child protection reviews to assess the emphasis placed on supervision in bringing about improved child protection systems. The paper concludes with some suggestions regarding the development of supervision in child protection services and the benets of such a strategy.
49

48

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 5

SUPERVISION
Before examining supervision in the specic context of child protection practice a brief overview of the key elements of supervision is discussed. Kadushins (1976) denitive text for the professional supervision of social workers outlined what are now the generally accepted functions of supervision: administration, education and support. Professional supervision is commonly dened as the relationship between a professionally trained senior member of sta within a human service organisation and a less senior member of sta, where the supervisor has managerial responsibility for the supervisee (Lewis, 1998). Some of the literature (Powell, 2004; Adams et al, 2004) refers to clinical supervision, which is dened as meeting four related individual needs: administrative, evaluative/reective, clinical, and supportive. There is general acknowledgement (Lewis, 1998; Trevithick, 2003) that self-awareness needs to be a component of supervision in human services. Psychiatrists use the term countertransference which refers to developing an understanding of ones reactions to a client. The essence of practice is dependent upon the workers understanding of their own boundaries, the recognition of factors either from the case itself or from their own life experiences which aect their perceptions and ultimately the relationship established between clients and worker and worker and worker (Lewis, 1998). Put simply, supervision is a time to reect and seek support (Adams et al, 2002). As Trevithick (2003) expresses it: good supervision is essential in order to rigorously monitor, clarify and understand reactions, and to decide how best to translate this intuitive knowledge if at all into practice. (Trevithick, 2003, p.170) Charles and Wilton (2004) argue that what distinguishes social work, and indeed the same might be said of a number of professions working in human services, is not what is done, but how it is done. Procedures and bureaucratic processes cannot achieve good practice on its own; aention has to be directed to communication paerns, family

dynamics and feelings. This traditionally has been a key role of supervision.

SUPERVISION IN THE CHILD PROTECTION CONTEXT

The stressful nature of working in child protection and the need to put in place supports for staff is well documented in the literature (Rushton & Nathan, 1996, Stanley & Manthorpe, 2004). Contextually, as Parton (2004) states, the overall impression is one of increased complexity, where the responsibilities of agencies have both broadened and intensied at the same time. (p.80).

of their work so they can adequately help the children and families they are serving. Supervision provides an opportunity to nurture the workers, to contain and understand their reactions and to recognise and process angry competitive and uncomfortable feelings. Workers unsupported, aacked or criticised by their colleagues are unable to work eectively (Calvert, 1992, p.171). Another analysis of supervision from an employers point of view also supports the need for beer supervision: Employers bear major industrial and moral responsibilities for supervising, evaluating, challenging, supporting and developing workers in the interests of good practice. Without good management of workers, good management of service delivery by workers can neither be expected nor ensured (Guransky, 2003, p.175).

There is an apparent association between the high rates of sta arition and the low levels of job satisfaction experienced by child protection sta; and the high levels of stress experienced by front line workers. Research conducted with child protection workers in Victoria (Gibbs, 2001) found practitioners who clearly stated their messages to supervisors about high workloads, stress and anxiety, were oen neither heard nor heeded. Indeed supervision in the area of child protection is oen viewed as the most demanding in the human services arena (Pecora, 2000). Some authors (Charles & Wilton, 2004) believe the experience of supervision of front line child protection workers parallels that of the system where crisis driven practice is common and aention to the detail of practice and skill development is neglected. Furthermore Gibbs (2001) concludes that, because of the crisis driven nature of the system within which they work, individual supervisors cannot and should not be blamed for problems with supervision. There is also a view in the literature (Gibbs, 2001; Calvert, 1992) that despite the emphasis given to supervision by professions such as social work and psychology, many workers continue to receive irregular supervision and/or are dissatised with the quality of supervision they receive. Calvert et al (1992) identied that sta in child protection services need beer and more timely supervision rather than supervision on the run. Supervision can preserve workers positive feelings about themselves and the value

In 2004, David Jones, Special Advisor to the Minister for Children, Young People and Families, in the United Kingdom, addressed Australian audiences (Jones, 2004). He described the work being done with child protection services in local authorities in England to raise the standard of service provision for children, young people and families. Jones emphasised that in improving quality in child protection work in England the investment that makes the biggest dierence is improving the quality of supervision to front line child protection workers. Jones (2004) described three key areas that must be the focus of supervision for child protection workers: that tasks are being done; that the stresses of the job are not overwhelming staff; that staff development and motivation is happening.

2003) which explains why professional supervision has had such diculty gaining credibility in human services seings is the emergence of the New Public Management (managerialist) paradigm which has dominated public sector management for nearly two decades. Managerialism is a set of beliefs and practices that assume beer management will resolve a wide range of economic and social problems (Alford, 1997; Davis, 1997). This discourse gives lile weight to the professional discourse of client engagement and need, relationship building, reective practice and professional discretion, but rather emphasises managerial procedures and decision making, direction, reducing professional autonomy, and increasing accountability. Hough (2003) argues that child welfare agencies exert control through the development of policy and procedure manuals and performance audits. He further suggests that organizations respond to scandals most frequently by the throwing of an even heavier blanket of administrative law over welfare practice (p.220). There is clearly some tension in accommodating both managerialist and professional discourses, within the one organization. The growth of managerialization, audit, procedural guidance and new systems of information technology and information management all seem to have contributed to an increasing complexity in the nature of the work as far as frontline professional are concerned. (Parton, 2004, p.89) In considering two signicant United Kingdom child protection inquiries 30 years apart Maria Colwell and Victoria Climbie Parton (2004) identies one of the common themes of the two inquiries as a severe lack of consistent and rigorous supervision (p.82). The study found that the Climbie report, in 2003, seemed to indicate that rather than resolving the problems, managerialism has simply changed their nature. (Parton, 2004, p.89) Managerial and professional discourses tend to view supervision dierently. The emphasis in child protection supervision from these dierent perspectives (managerial and professional) might look like: accountability versus autonomy, expediency versus exploration, decision versus reection, and
51

MANAGERIALISM AND PROFESSIONALISM

One analysis in the literature (Parton, 2004; Hough,

50

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 5

policy/procedure versus professional judgement. However, I would argue that this interpretation of managerialism versus professionalism is too simplistic; that child protection systems are able to accommodate both managerialist and professional paradigms and are beer for the inclusion of both. I will return to this point later in this paper. Against this background of the importance of supervision in the child protection context, and the tension of managerialist and professional paradigms, it is useful to analyse recent Australian child protection reviews to examine what is said about supervision.

supervision. These all provide an additional depth to the supervision process and are extremely valuable, and sometimes overlooked, in models of supervision in child protection systems. In essence a documentary analysis of the reviews was carried out to identify references to supervision that led to recommendations. When supervision was mentioned or discussed (or related terms where there was the implication of supervision) the comments were extracted and analysed in relation to their direct relevance or otherwise to the practice of supervision. A comparison of relevant supervision recommendations between the reviews was also made.

Children: Ensuring Safety and Quality Care for Children and Young People (July 2004) the Audit formed part of the ACT Review and specically examined the electronic and paper records of 150 children for whom reports of abuse or neglect were made while they were in care. An analysis of the review concludes that limited aention is paid to s upervision. Instead the focus of the review is on recommendations that address workload management and training. The Vardon Report was substantially focused on three questions posed early in the report in respect to children in care: How many children do you have?; Where are they?; How are they? This emphasis is reected in the title of the Review The Territory as Parent. In total there are 114 Recommendations (47 in the Commissioner Vardons report and 67 in the audit report). Of the total 114 recommendations only 6 could be identied broadly relating to supervision. Interestingly one recommendation of the Audit related to supervision not of child protection workers but importantly of stakeholders external to the Department. Specically this recommendation (9.2) referred to the need to skill workers in non-government agencies, foster carers and kinship carers on: age appropriate discipline; behaviour management techniques; and age appropriate developmental expectations. One of the earlier recommendations (3.1) under the heading Best Practice, specically relates to training in the risk assessment framework and could equally be referring to a role for supervision, however, supervision is not specically mentioned. Recommendation 8.9 acknowledged the pressures on child protection sta and supervisors in the ACT. It recommends a workload management solution to manage the work of the team leader and to limit the caseloads of the child protection workers, so that child protection workers can be supported and supervised. Under the heading Work not completed

for beer training and supervision in completing appraisals and writing appraisal outcome reports. The detail of appraisal and AORs1 should be checked by supervisors. (p.105). In summary then, the ACT Review, appears to only reference supervision as it relates to issues like completion of work, workload management, training and compliance by child protection workers. It does see a bigger role for supervision extending beyond the Department and child protection workers, to residential care workers and foster carers. The ACT Review does not dene supervision in any way and perhaps the authors did not recognise the central place supervision has in service improvement.

REVIEWS INTO CHILD PROTECTION

Three reviews into Child Protection in Australia have been selected because they are relatively recent (within the last 3 years) and all arose due to a crisis of condence in child protection systems. The reviews are: The Territory As Parent: Review of the Safety of Children in Care in the ACT and of ACT Child Protection Management by Cheryl Vardon Commissioner for Public Administration, May 2004, Australian Capital Territory. Our Best Investment: A State Plan to Protect and Advance the Interests of Children by Robyn Layton QC, March 2003, South Australia. Protecting Children: An inquiry into the Abuse of Children in Foster Care by Brendan Butler SC, Crime and Misconduct Commission, January 2004, Queensland. There are debates about the dierent meanings of terms such as supervision, professional supervision, clinical supervision, and even consultation. This paper takes a broad interpretation of supervision so as to identify any review recommendations that either mention supervision specically, or use terms such as: consultation; performance appraisal; best practice; and training, where there is the implication that supervision may be involved. The inclusion of these terms for the purposes of this paper is not to minimise the importance of dierent types of supervision such as peer supervision, team supervision, external supervision and informal

THE ACT REVIEW

I have some specic professional knowledge of the ACT Review having worked in the organisation which was under review. At the time I became responsible for managing the review team that supported the external consultant, Ms Gwenn Murray in auditing and reviewing cases. This audit formed a critical part of Commissioner Vardons Review. The reason for the ACT Review relates to lack of compliance with Section 162(2) of the Children and Young People Act 1999, by the then Department of Education, Youth and Family Services (the Department responsible for child protection at the time). In summary the ACT Children and Young People Act 1999 requires under section 162(2) of the Act that the Chief Executive provide a copy of reports of abuse or neglect of children and young people for whom the Chief Executive has Parental Responsibility, to the Oce of the Community Advocate (an ACT oversight body). In December 2003 the Minister responsible was informed by the Chief Executive of the (then) Department of the failure to comply with s162(2) of the Act. The Commissioner for Public Administration, Cheryl Vardon, was engaged by the Chief Minister to undertake the review in January 2004. Cheryl Vardons review report was titled The Territory As Parent: Review of the Safety of Children in Care in the ACT and of ACT Child Protection Management. The report The Territorys

THE SOUTH AUSTRALIAN REVIEW

The South Australian Review (Layton, 2003) emerged aer a twenty-year history of reviews into child protection in the State. The governments request of Layton and her team was for a state plan for child protection incorporating current research trends and distinctive economic and social features of the state (Layton, 2003). The South Australian Review has 206 recommendations which clearly emphasise a whole of government approach to child protection; early intervention; legislative reform; structural reform; improvements to case management; and training. There is some mention of supervision in the South Australian Review, however much more signicant aention is paid in the recommendations for improved case management and training. Both training and case management assume the presence of supervision but this is not specically discussed in this Review. Recommendation 26 suggests the development of a uniform but exible system of performance measurement of eciency, eectiveness and appropriateness of services for individuals, families or groups. While there is no mention of supervision, one might envisage that supervision could be the means by which such performance measures could be implemented. A number of recommendations (Recommendations 30, 39, 42, 81, 155) appear to relate particularly to
1

(Recommendation 5.5) the Review notes that: In some cases this (work not completed) is a consequence of inadequate resourcing and competing priorities in an over-stretched child protection system. There is a need

Appraisal Outcome Reports

53

52

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 5

supervision and consultation although this is not made explicit. Specically these are references to: interagency collaboration; the development of workload measures; support for regular training and sta development; interagency training. A clear reference to supervision is made towards the end of the Review. Recommendation 198 suggests the need to provide sta with additional specialised supervision and support in the delivery of culturally appropriate services. Of the 206 recommendations in the South Australian Review, 7 relate to supervision. The SA Review does take a sector-wide approach and clearly recognises the workforce issues in child protection. It provides few specic references to professional supervision but perhaps assumed its existence and as a result there is an emphasis on training, professional development and support of sta.

There were only three specic recommendations (5.19; 7.22; 7.30) in the Queensland Review related to supervision. The rst (5.19) referred to support for front-line workers by senior practitioners including the routine review of clinical decisions. The second (7.22) suggested training and support of sta in evidence based parenting practices. The nal recommendation (7.30) recommended consideration of mentoring programs for foster carers and children in care. This recommendation appeared to refer to how foster carers were supervised and how sta who have contact with foster carers are provided with support and supervision. A predecessor to the Queensland (CMC) Review was the Report of the Commission of Inquiry into Abuse of Children in Queensland Institutions (1999) chaired by Leneen Forde (Forde Inquiry). Of interest is its mention specically of professional supervision of sta in the residential/institutional context: Poor supervision and sta support have also contributed to a high-risk environment. Child care is dicult and challenging, and is made even more so where conditions are poor. Work hours were oen extended, and a heavy workload was a consistent feature of the work of carers in orphanages, which contributed to the creation of an abusive environment. In circumstances of poor supervision, no inspections and lile accountability or external advocacy for children, caregivers wielded almost unlimited power over the children. (Forde, 1999, p.20) Forde then made a specic recommendation about supervision (Recommendation 36, Chapter 11): That by December 2000 the Department: review issues aecting eld sta responsible for children in care, including excessive caseloads, inadequate personal and professional supervision, high turnover, insucient resources and training, and implement measures to address them review stang and supervision arrangements within detention centres, with risk assessment procedures applied to determine appropriate supervisory arrangements and the optimum stang balance of permanent

to casual sta to provide cost-eective service delivery by experienced sta, while minimising risk. (Forde, 1999, p.273)

THEMES IN RECOMMENDATIONS OF THE THREE REPORTS

Common themes, related broadly to supervision, emerge in the ACT, South Australian and Queensland Reviews. Recommendations have been clustered under the broad themes in Table 1. Table 1
Caseload formula/workload measure: Availability of supervisors: Better training/professional development/ accreditation: Better supervision (incl. checking of work) policies and practices to increase the skills of the workforce: Training, supervision & support of residential workers and carers: Development of performance measurement: Interagency case management/ training: Development of senior position/s to provide consultancy/expert advice: ACT 8.9; SA 39 ACT 8.9 ACT 5.5; SA 42; SA 155; Qld 7.22 ACT 5.5; ACT (Audit) 3.1 ACT (Audit) 9.2; Qld 7.30 SA 26 SA 30; SA 81 SA 198; Qld 5.19

What is recommended is good and sensible, but it is minor in the scheme of recommendations, especially given the important place of supervision in the research literature on child protection. It should be acknowledged that the role and function of supervision may have been assumed (none of the Reviews aempted to dene the supervisory relationship). There are clear recommendations in the reports on related areas, for which supervision forms some foundation or has a reinforcing or review role. These include recommendations on: case management; training; performance management; mentoring; support; and professional development. Furthermore in each of the reviews, supervision in the context of child protection appears to refer to monitoring and checking by senior sta of work done by junior sta or alternatively consultation on complex cases. There is no discussion of the range of supervision models and the possibilities each could bring to improving the performance of child protection workers. There are at least three possible explanations for the lack of any specic mention or discussion of supervision in the reviews. Firstly, the context within which each of the reviews was established meant that the role and function of supervision in child protection was not the main focus and was not discussed in any detail but merely assumed. In her foreword for the SA Review, Robyn Layton identies the prime purpose of her review as being to provide an overall framework for child protection practice which would assume a framework for the supervision of that practice. Some authors (Stanley & Manthorpe, 2004) suggest that inquiries into child protection have four purposes: learning; disciplining; catharsis; and reassurance, and that the learning in inquiries is inevitably limited to the inquirys primary purpose. Secondly, the professional backgrounds of the individuals conducting each of the reviews may have resulted in a lack of understanding of the critical role that supervision plays in human service professions. In particular, the role supervision plays for frontline child protection workers faced with dicult and demanding work, in a resource depleted sector, may not have been understood. Robyn Layton QC (SA)
55

THE QUEENSLAND REVIEW

The Queensland Review was conducted by the Crime and Misconduct Commission (CMC) at the request of the Premier due to a series of Courier Mail articles in June and July 2003 highlighting dramatic claims of abuse of children in foster care. In the summary report the CMC notes: Collectively, the evidence indicates organisational failure to equip ocers at virtually all relevant levels of the Department of Families with the information or skills and resources to make the right decisions in the best interests of children in care The facts of the particular maers considered by the CMC underscore the ultimate eect of these systemic failings: they have human costs that should not be tolerated as part of any modern state-administered child protection service. (CMC 2003, p.98) One of the key ndings of the report is the need for consideration of a whole of government response and included in the ndings is the recognition of the importance of supporting sta through appropriate induction training and professional development opportunities.

The top recommendation referred to in all three reviews, involved the need for beer training, improved professional development and the development of accreditation systems. Four of the recommendations were mentioned in two of the three reviews, including: the development of caseload formulas and workload measures; the development of beer supervision through policy and practice; increasing training and supervision to residential workers and carers; and the development of senior position/s to provide expert advice/consultancy.

ANALYSIS OF HOW SUPERVISION IS DEALT WITH IN THE REVIEWS

The rst observation is the virtual absence of comment about supervision in the three reviews.

54

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 5

and Brendan Butler SC (Qld) are both from the legal profession and Cheryl Vardon (ACT) is a career public servant. Thirdly, the unease between professional and managerial roles and demands may have meant the issue was too problematic, or too big, to struggle with in the reviews. One of the hallmarks of managerialism is the profusion of instruments for assessing need, assigning services, and monitoring performance. This checklist approach constrains the construction of service users needs, and can exclude information crucial to adequate needs assessment. (Meagher & Parton, 2004, p.20) Supervision in some organisations is narrowly dened as line supervision and is almost solely about performance management and monitoring. This reects the inuence of managerialism on human service organizations in the past 20 years. In an age of child protection inquiries where risk is constantly evaluated, some commentators (Stanley & Manthorpe, 2004) observe supervisors spending less time on casework supervision and more time on administrative supervision. Administrative Supervision does not capture the inherent complexities of work in human service organisations. The focus of supervision shied from the 70s and 80s, where it was concerned with emotional and professional support, to a focus in the late 80s and 90s with an emphasis on performance appraisal, monitoring and workload management. It (supervision) can become a management tool of accountability and eciency. Equally, it can be used to enhance professional development and there by practice and service provision. (Adams et al, 2002, p.103) Another aspect is that these reviews emerged against a background of lack of condence in the child protection systems. As a result the major focus of the three reviews was on accountability. It could be argued that accountability could eectively be addressed through supervision but that where the reviews favour changes to structures, policy and legislation, supervision is somewhat sidelined. As
56

Gibbs concludes: Rather than concentrating on the development of eective supervision structures to assist workers to function in such a personally and professionally demanding world, the literature indicates that public child welfare organisations have concentrated more on the issue of accountability with the proliferation of policies and procedures being the predominant response (Gibbs, 2001, p.325). Clearly the danger with ongoing problems in the child protection systems and regular reviews is that supervision may increasingly be seen solely as a tool for compliance, rather than for its broad purposes such as providing support to sta in a range of areas to carry out their jobs.

Accreditation of supervisors would improve quality. Whilst aention is paid to the role of supervisors, and training programs do exist, generally much more could be done in terms of training and recognition. An award following training (and possibly a number of practice hours) that leads to accreditation would raise the standard of supervision. Moreover, accreditation of services that are judged to provide quality supervision would begin to go seriously to the issue of quality. Recognition, perhaps in the form of awards for excellence, in supervision at individual, supervisor, team and organisational levels. There should be encouragement for organisations to continue to support supervision in practical ways such as allowing people to have regular uninterrupted time with a supervisor in a quiet, private space. This would mean substantial change (being lead and modelled by managers) in workplaces that are crisis driven. The use (and resourcing) of technology for supervision in regional, rural and remote areas such as video conferencing, teleconferencing and online forums would also assist. There could be consideration of the development of peer supervision groups in child protection (and potentially involving health and community workers). Such peer groups allow for a range of ideas and approaches that acknowledge the complexity of working in this oen-challenging eld. There could be consideration of supervision as one of many tools that provide support for practice. A project could be created to dene and develop the entire tool kit. The development of a culture of reective practice where supervision and debrieng encourages learning could be created through the use of regular critical incident reviews, but also reviews of situations which highlight excellence in practice. This process can then inform changes to practice, policy, legislation and support practitioners in their role.

three child protection reviews to assess the emphasis placed on supervision in bringing about improved child protection systems. Unfortunately, this review of the three child protection reviews provides lile in direction regarding the role, function, strengthening or redening of supervision for improved practice. The paper concludes with some suggestions regarding the development of supervision in child protection services. Supervision is central to so many aspects of child protection work. Good quality supervision, provided to sta on a regular basis, will help them feel valued and lead to greater job satisfaction. Supervision leads to increased critical reection and increased skills for sta. In turn, the development of good supervision may mean higher levels of sta retention and the possibility that sta will take on supervisory positions. Supervision should be oered by higher level professionals who have developed skills and themselves experience a high degree of support and satisfaction (Lonne & Thompson, 2005). A focus on improving supervision practice (rather than another review into child protection, at substantial cost, to tell us what we already know and understand) would go a long way to improving standards and quality in child protection. Supervision needs to have a fundamental place in the building of beer child protection systems in this country. Ultimately, and centrally in our work, good quality supervision is benecial for the children and families being assisted by child protection sta.

POSSIBLE WAYS FORWARD

Whilst the recommendations of the reviews that do address supervision are welcomed, their limited scope is disappointing. The system cannot be reliant on reviews of child protection systems to achieve change in supervision practices. There are a range of strategies that sit comfortably between managerialist and professional paradigms that could be introduced to assist in the development of more robust support for practice in child protection. Returning now to the analogy of the tree, branches and leaves that could be drawn on the bough of supervision, on the tree of child protection, might include some of the following suggestions. National standards or guidelines for the provision of supervision in the child protection sector could be developed by peak professional bodies, building on existing expectations about supervision provision, in conjunction with University Schools of Social Work and Psychology. Additionally, competencies for supervisors in child protection could be developed. The Australian Association of Social Workers in conjunction with the National Mental Health Strategy (with Australian Government funding) produced, some years ago now, a very useful publication that sets out competencies for mental health social workers. A similar project in child protection would be most welcome.

REFERENCES
Adams, R., Dominelli, L., & Payne, M. (2002) Social Work: Themes, Issues and Critical Debates. (2nd ed.) Basingstoke, UK., Palgrave in association with The Open University. Alford, J. (1997) Towards a new public management model: Beyond managerialism and its critics, in Considine, M. and Painter, M. (eds), Managerialism: The Great Debate, Melbourne, Melbourne University Press, 152-72. Calvert G., Ford A., & Parkinson P. (eds) (1992) The Practice of Child Protection Australian Approaches. Sydney, Hale & Iremonger, Suthwood Press.

CONCLUSIONS
In this paper I have provided a brief overview of the common and accepted understandings of the concept of supervision and analysed the recommendations of

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 5

57

ARTICLE
Charles, M. & Wilton, J. (2004) Creativity and Constraint in Child Welfare in Lybery, M. & Butler, S. (eds.) Social Work Ideals and Practice Realities. New York, Palgrave MacMillan (179-199). Forde, L. (1999) Commission of Inquiry into Abuse of Children in Queensland Institutions. Report. Brisbane, Queensland Department of Families, Youth and Community Care. Gibbs, J. A. (2001) Maintaining Front-Line Workers in Child Protection: A Case for Refocusing Supervision, Child Abuse Review,10, 323-335. Gursansky, D., Harvey, J. & Kennedy, R., (2003) Case Management: policy, practice and professional business. Crows Nest, N.S.W., Allen & Unwin. Hough, G. Enacting Critical Social Work in Public Welfare Contexts in Allan, J., Pease, B. & Briskman, L. (2003) Critical Social Work: An Introduction to Theories & Practices. (Chapter 14) Crows Nest, N.S.W., Allen& Unwin. Jones, D. (2004) Geing the Best for Children. Lectures in Australia for the Early Childhood Foundation. Canberra, September. Kadushin, A. (1976) Supervision in Social Work, New York, Columbia University Press. Lewis, S. (1998) Educational and organisatioinal contexts of professional supervision in the 1990s. Australian Social Work, 51(3), September, 31-39. Lishman, J., in Campling, J. (2002) Social Work: Themes Issues and Critical Debates Basingstoke, U.K., Palgrave in association with The Open University. Lonne, B. & Thomson, J. (2005) Critical review of Queenslands Crime and Misconduct Commission inquiry into abuse of children in foster care: Social works contribution to reform. Australian Social Work, 58(1), March, Meagher, G. & Parton, N. (2004) Modernising Social Work and the Ethics of Care. Social Work and Society. 2(1) Murray, G., (2004) The Territorys Children: Ensuring safety and quality care for children and young people. Report on the Audit and Case Review. Canberra, ACT, Commissioner for Public Administration. July. Parton, N. (2004) Maria Colwell to Victoria Climbie: Reections on Public Inquiries into Child Abuse a Generation Apart. Child Abuse Review 13, 80-94. Pecora P., Whiacker J., Maluccio A., & Barth R., (2000) The Child Welfare Challenge ePolicy, Practice & Research (2nd ed.) New York, Aldine de Gruyter. Powell, D. (2004) Clinical Supervision in Alcohol and Drug Abuse Counselling. San Francisco, Jossey Bass. Stanley, N. & Manthorpe, J. (2004) The Age of Inquiry Learning and blaming in health and social care London, Routledge, Taylor & Francis Group Trevithick, P. (2003) Eective relationship-based practice: a theoretical exploration Journal of Social Work Practice, 17(2).

A national comparison of statutory child protection training in Australia

Leah Bromeld PhD and Robert Ryan
ABSTRACT
The aim of this project was to provide a national audit of statutory child protection learning and development units and the training provided by such units at a point in time (October 2005 March 2006). There was very lile dierence in the broader purpose of learning and development units, or the specic aims of entry-level training. All training was mapped to some extent to the national competencies, thus the content of entry-level training programs was very similar across jurisdictions. Although the content was similar, the structure in entry-level training varied signicantly across jurisdictions in terms of when training began, the total duration of the training period, length of training blocks, and the role and length of workplace learning in the training process. The greatest area of variation was the size of training units, with the number of dedicated child protection trainers ranging from two to 29. The paper concludes with a discussion of the implications of these ndings for researchers, policy-makers and practitioners.

THE CHILD PROTECTION REVIEWS

Layton, R. QC (2003) Our Best Investment: A State Plan to Protect and Advance the Interests of Children. Adelaide, South Australian Department of Human Services. Queensland. Crime and Misconduct Commission (2004) Protecting Children: An inquiry into the Abuse of Children in Foster Care. Brisbane, Queensland Crime and Misconduct Commission. Chairperson: B. Butler SC. Vardon, C. (2004) The Territory As Parent: Review of the Safety of Children in Care in the ACT and of ACT Child Protection Management. Canberra, ACT, Commissioner for Public Administration. ACKNOWLEDGEMENTS: The authors are members of the Australasian Statutory Child Protection Learning and Development Group. They wish to thank their colleagues in the Group who contributed to this project, in particular the other members of the Mapping Project working party: Ms Pauline Cole (Children Youth and Family Services, South Australia), and Dr Lynette Arnold (Australian Centre for Child Protection). AUTHORS: Dr Leah Bromeld
Research Fellow and Assistant Manager National Child Protection Clearinghouse Australian Institute of Family Studies.

A NATIONAL COMPARISON OF STATUTORY CHILD PROTECTION TRAINING IN AUSTRALIA

As a federation of states and territories, Australia does not have a unied approach to child welfare, but rather eight dierent systems. Research shows that the child welfare systems in Australian states and territories are more similar than dierent (Bromeld & Higgins, 2005). Given the apparent similarity, there may be some benet in the sharing information and experience across jurisdictions to avoid duplication of eort and to gain maximum benet from resources expended in this area. There is a need for specialist vocational training to prepare incumbents for the role of statutory child protection professionals. The Australasian Statutory Child Protection Learning and Development Group was established to assist statutory child protection educators in preparing incumbents for the role of statutory child protection professional. The Group comprises representatives with learning and development responsibilities in every Australian state and territory, and New Zealand1. In addition, there are representatives from the Australian Centre for Child Protection (at the University of South Australia) and the National Child Protection Clearinghouse (at the Australian Institute of Family Studies) (Bromeld, 2006).
1

Mr Robert Ryan
Principal Training and Staff Support Ofcer Queensland Department of Child Safety.

DISCLAIMER:
The views expressed here are those of the authors and do not necessarily reect the views of the institutions at which they work.

ADDRESS FOR CORRESPONDENCE: Dr Leah Bromeld National Child Protection Clearinghouse Australian Institute of Family Studies 300 Queen Street Melbourne Victoria 3000 Phone: +61 3 9214 7888 Fax: +61 3 9214 7839 Email: leah.bromeld@aifs.gov.au

New Zealand did not participate in the project described in this paper. 59

58

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

This project was undertaken primarily to enhance the goals of the Australasian Statutory Child Protection Learning and Development Group, which are to: facilitate the sharing of training resources; discuss approaches jurisdiction; to training in each

discuss what works and what doesnt work; share initiatives and innovation; avoid duplication of eort; identify commonalities and dierences between approaches in dierent jurisdictions; articulate the link between training, and recruitment and retention; discuss approaches and strategies for responding to shared problems; and support research to facilitate the above goals (Bromeld, 2006). This information is also likely to be of interest to policy makers to assist them in making decisions that balance the duel imperatives of cost eciency and quality service provision. In addition, cost savings may also be identied in the training area: for example it may be more cost eective to purchase places in specialised training in another jurisdiction than to develop and provide the training. The information collated for this project may also prove useful to researchers in assisting them to determine: the generalisability of research from one jurisdiction to another, priorities for future research, and the feasibility of multi-site projects crossing jurisdictional borders. Practitioners may also nd this information informs them about the training culture in child protection organisations, the requirements that they would need to full were they to undertake a career in child protection, and to inform applications they might make for recognition of prior learning. The purpose of this paper is to describe statutory child protection training in Australia. The relative merits of the dierent training programs will not be compared as there is a lack of evaluative materials to undertake such a task. However, comparisons of the similarities and dierences in training provided in the dierent jurisdictions are presented. Specically,

in this paper the ndings from a national audit of statutory child protection training programs are presented. Findings include, a comparison and discussion of the size of statutory child protection learning and development units in Australia, a discussion of the issues associated with existing knowledge and skills of workers entering the child protection sector, and the comparability of entrylevel training for statutory child protection workers in Australia. In addition, the authors discuss the dierent means of determining whether or not the aims of entry-level training have been achieved.

completion. Once the surveys were completed and returned, the authors examined the data to determine broadly the similarities and dierences in the provision of statutory child protection services in Australia. This description was then discussed by the wider Group at the March 2006 meeting. Revisions were made to provide additional clarication prior to the information and accompanying descriptions being made publicly available. Because statutory child protection services are subject to frequent change this process was undertaken within a tight timeline to ensure that the information provided had not become dated by the time it was made publicly available. This paper presents ndings from the mapping project in relation to minimum entry-level training. The information presented was accurate when provided by jurisdictions during the period October 2005 March 2006.

described in Table 1. One of the most basic points of comparison and an area of primary interest to policy makers and funding bodies is the size of statutory child protection learning and development units. The number of trainers varied signicantly between jurisdictions (see Table 2). There are many reasons for variations in the size of training units across Australian jurisdictions. Population, geography and demand combine to inuence the number of child protection workers in direct service delivery, and in turn inuence the number of training sta required to service the workforce. The scope of the training units responsibilities also impacted on the size of the units (i.e. does the unit only train child protection workers or are they responsible for training more widely to professionals within and outside the Department). There were signicant dierences in the number of child protection workers involved in direct service delivery across states and territories. The number of child protection sta involved in direct service delivery within the organisation ranged from 115 in the ACT to 1479 in New South Wales. A large proportion of the variation in stang levels for direct service delivery is aributable to dierences in population size (see Table 2).

MAPPING PROJECT
In August 2005, the Australasian Statutory Child Protection Learning and Development Group determined to undertake a mapping exercise. The aim of this exercise was to provide a national audit of statutory child protection learning and development units and the training provided by such units in Australia. The wider Group which comprised representatives from each jurisdiction present agreed to support the project by providing the information required within set timelines. The Australian Institute of Family Studies agreed to support this project and for sta from the National Child Protection Clearinghouse to undertake the work as part of its National Comparisons research program2.

STATUTORY CHILD PROTECTION LEARNING AND DEVELOPMENT PROGRAMS IN AUSTRALIA

The departments that are responsible for operating the child protection system within each jurisdiction, and the name of the learning development unit that provides statutory child protection training are

Table 1. Responsibility for statutory child protection training

Name of Department ACT Ofce for Children Youth and Family Support, which is part of the Department of Disability, Housing and Community Services Department of Community Services Family and Childrens Services Department of Child Safety Families SA which is part of the Department for Families and Communities (DFC) Department of Health and Human Services, Division of Child and Family Services Ofce for Children which is part of the Department of Human Services Department for Community Development Acronym OCYFS Name of the training branch or unit The Training and Community Education Unit

METHOD
The working party met to establish the type of information that would need to be collected, this information was compiled into a dra self-report data pro forma with a series of open-ended questions (for example, What are the minimum entry level qualications required for the appointment of Child Protection sta?). The dra data pro forma were circulated to the working party several times for revision. The nal version was then piloted in two states (Queensland and South Australia) and underwent a nal revision process before being circulated to the remaining jurisdictions for
2

NSW NT QLD SA TAS VIC WA

DoCS FACS DChS Families SA DHHS DHS DCD

Learning and Development Branch Service System Improvement Unit (SSIU) The Training & Specialist Support Branch (TSSB) Learning and Development Centre The Child Protection Services Support Unit Child Protection and Juvenile Justice Professional Development Unit (CP&JJPDU) The Learning Development Unit based at Community Skills Training Centre

The National Comparisons research program aims to compile and describe legislation, policy and practice information for Australias eight states and territories in the elds of child abuse prevention, child protection and out-of-home care.

Note: Acronym refers to the acronym most commonly used to refer to the program by its staff and within the community. In some jurisdictions the acronym originates from the Departmental name (e.g., Tasmania), in others the acronym is derived from the program name (e.g., South Australia).

60

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

61

Table 2. Child protection and training sta relative to the population size
Population New South Wales Victoria Queensland Western Australia South Australia Tasmania ACT Northern Territory 6,774,200 5,022,300 3,964,000 2,010,100 1,542,000 485,300 325,200 202,800 Notications 133,636 37,523 40,829 3,206 17,473 10,788 7,275 2,101 Child Protection Staff 1479 937 1432 1198 600 220 115 120 All Trainers 63 unknown 24 unknown 19.6 4 8 2 Child Protection Trainers 29 9 24 3 5.2 3 2.6 2

The size of training units and the number of staff involved in direct service delivery is not directly comparable across jurisdictions as a variety of factors combine to explain such differences.

in case management and a supervised casework placement are also considered. Western Australia was the only jurisdiction where a qualication was not mandatory as part of the entry-level requirements. Entry-level qualication requirements were lowered in some circumstances (for example, there are no essential entry requirements for Aboriginal sta in New South Wales).

TRAINEES EXISTING KNOWLEDGE AND SKILLS

The very existence of statutory child protection learning and development units in every state and territory reect the need for specialist vocational training to prepare incumbents for the role of statutory child protection professionals. However, in the TAFE and University sector some courses may require students to demonstrate that they already possess a minimum level of knowledge to undertake the course (most usually reected as pre-requisites). Statutory child protection organisations undertake the same basic process by seing minimum entrylevel qualications and then prescribing mandatory training to ensure encumbents are job ready. Essentially statutory child protection organisations employ those people who they assess as being most ready to be trained as a statutory child protection worker. Alternately, at the other end of the continuum new sta may be employed who already have extensive skills and experience in the child welfare area (e.g., they may have experience as a statutory child protection worker in another jurisdiction) such that the need for them to participate in training at all is minimal. In this section we compare minimum entry-level qualications across jurisdictions and procedures for Recognition of Prior Learning.

RECOGNITION OF PRIOR LEARNING

Some people will have some or all of the required outcomes or competencies for components in formal training programs. Prior learning principles recognise learning regardless of how it occurred. It doesnt maer how the skill or information was learnt, the importance is placed on the skill and the fact that you can demonstrate that skill (Tovey & Lawlor, 2004). Recognition of prior learning (RPL) or recognition of current competence (RCC) is a component of many accredited training programs in both the VET and University sectors. The benets of RPL are two-fold: RPL values the skills of experienced practitioners and provides them with the opportunity to gain accreditation for the skills they have developed on the job. RPL is also resource ecient as it enables training units to avoid providing unnecessary training. RPL may aid in both recruitment and retention as it provides experienced practitioners with the opportunity to earn an additional qualication. Arguments against RPL for statutory child protection training are that the legislation and policy environment varies in each state and territory making RPL impractical, and that in addition to skill development training provides an opportunity to engender a particular organisational culture in trainees. Procedures to recognise prior learning might include providing documentation on previous qualications such as a certicate of graduation or academic transcript, siing a wrien test to assess knowledge or undertaking a competency-based assessment such as a role play to demonstrate skills gained through prior experience. Perhaps reecting the advantages and disadvantages of RPL, there is no consistent approach to the issue of RPL in Australia. The ACT, New South Wales and Tasmania have RPL processes
63

NOTE: Population data were sourced from the Australian Bureau of Statistics (2005) Notication data were sourced from the Australian Institute of Health and Welfare (2006) Tasmania and WA use Senior Practitioners, Team Leaders etc. to assist in the delivery of training, thus reducing the number of dedicated child protection trainers.

However, population size alone does not explain dierences in workforce size: Victoria has the second highest population but is ranked fourth in terms of workforce size, and the Northern Territory which has the smallest population is ranked sixth in direct service delivery workforce size. Some of these dierences may be aributable to geographic dierences. It is possible that jurisdictions with a population spread over a wide geographic area, which includes remote regions (e.g., Northern Territory, and Western Australia) require more sta to service the population than jurisdictions with a highly concentrated population (e.g. Victoria and the ACT). Demand on the service system (e.g. notications) also varies signicantly across jurisdictions (see Table 2). Service demand appears to have a closer association with direct service delivery stang levels than either geography or population size. Reasons for variation in service demand have been discussed elsewhere (Australian Institute of Health and Welfare, 1999; Bromeld & Higgins, 2004). The scope of the training units responsibility also impacts upon stang levels within training units (i.e. whether the unit was responsible for child protection training or training all department sta, and the amount of external professional groups for which the unit has training responsibilities). For example, in South Australia the training unit that delivers

statutory child protection training also provides training to youth workers and nancial counsellors among others. Training units in Queensland, and Victoria had a child protection focus, however, Victorias child protection training unit sat within the broader training unit for Juvenile Justice, Adoption and Permanent Care. Training units in New South Wales, South Australia, the ACT and Western Australia had a broad responsibility for training within the Department. All jurisdictions stated that they trained groups that were not employees of the Department. External groups typically included Police, sta in specic non-government community service organisations and mandated notiers. These factors alone are unlikely to explain why training units range in size from two in the Northern Territory to 29 in New South Wales. On the basis of this data it would appear that there are also signicant dierences in the level of resources invested in training across jurisdictions. In addition to the issues discussed, decisions about the resourcing of training units are likely to be informed by resources available across the departments, historical decisions in relation to training, the organisational commitment to a learning culture, planned changes, retention programs and recruitment numbers.

ENTRY-LEVEL QUALIFICATIONS
The core entry-level qualication requirement for caseworkers is essentially the same in all jurisdictions. In most cases this is a Bachelor degree in elds such as Social Work, Psychology or the Social and Behavioural Sciences. However in some jurisdictions a Diploma level qualication is also considered in the recruitment process. For example, Victoria accepts Bachelor of Social Work and Diploma of Welfare Studies, but other degrees or diplomas with a unit

62

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

in place for in-house training, and Queensland, South Australia and Western Australia are currently developing RPL processes. The Northern Territory and Victoria do not oer RPL.

was established to provide training across all classications in the organisation in order to ensure that all sta are suitably equipped to provide excellent service (SA). We develop sta by running courses that build their capacity to respond eectively to children, young people and their families (ACT). To improve our workforce capability and performance by beer supporting our sta in the work they do (NSW). The nding that all Australian learning and development units responsible for training statutory child protection workers share the same goals was reinforced when we looked specically at the aims and objectives of entry-level training. The core focus for most programs was around the development of the knowledge, skills and abilities that are required for child protection work. All States and Territories (except Western Australia) currently have formal entry-level training programs.

Table 3. Structure of entry-level training

Start ACT NSW NT QLD Within 1-month Within 1-month ASAP Within 6-months 6 months 22-weeks (eight 1-week training blocks that are followed by 2-weeks workplace learning) 5-day induction, plus an additional 2-day case management and statutory client engagement module 9-weeks (3-weeks delivered centrally. Weeks 4&5 eld phase of the training where they are inducted into the ofce using a self paced learning booklet. In the nal four weeks of training they complete two blocks of training at the central training unit and a one-week placement with a non-government organisation) SA TAS VIC WA ASAP ASAP Day 1 Not yet determined Essential within 6-months, required within 2-years 2-week (10 day) induction program with a subsequent 3-day follow-up 7-weeks (three 4-day practice clinics that are followed by 11-days of workplace learning) Western Australia does not have a mandatory entry-level training program at present, but are in the process of developing an induction program. The proposed induction program will include 4-weeks full-time face-toface contact interspersed with 4-weeks workplace learning NOTE: Western Australias induction training is being developed at present. The recorded duration of training is based on the initial proposal for the induction program. Period over which training is completed

STATUTORY CHILD PROTECTION ENTRYLEVEL TRAINING GOALS OF TRAINING

There are a set of national competencies for statutory child protection workers recognised under the Australian Qualications Framework. The Australasian Statutory Child Protection Learning and Development Group were involved in the development of these standards (Bromeld, 2006). Competency-based training is an approach to training that is structured around outcomes for the learner that are linked to actual job performance rather than knowledge acquisition, that is, what can the person do at the end of their training and does the training make them job ready?. Queensland, South Australia and Victoria were the only jurisdictions that identied their training as competency-based. However, all other jurisdictions reported that their core training was mapped to some extent against all of the national competencies. This is perhaps the best evidence available to suggest that training in Australian jurisdictions is more similar than dierent, and indeed that the role of statutory child protection practitioner does not vary greatly across jurisdictions. Consequently the training needs of practitioners in these jurisdictions are also likely to overlap signicantly. Consistent with the nding that child protection services in Australia are more similar than dierent, all child welfare learning and development units provide training programs for essentially the same purpose: quality service provision. This was demonstrated in each jurisdictions response to the question, What is the purpose, vision or mission of the training branch? For example: Our mission is to lead and develop professional practice in our sta. This will directly contribute to beer outcomes for the children and young people whom we serve (VIC). The Learning and Development Centre

STRUCTURE OF ENTRY-LEVEL TRAINING

The way in which training is designed, the skills of the facilitator and the model of the program has a critical impact on the capacity of the training to achieve results both for the learner and for the organisation. There was a great deal of variation in the structure of entry-level training, particularly with regard to when training commences, the duration of training (see Table 3), and the role of workplace supervisors in the support and assessment of trainees.

CONTENT OF ENTRY-LEVEL TRAINING

A comparison of the modules covered in each jurisdiction can be found in Table 4. There is a signicant degree of overlap between Australian jurisdictions in entry-level training, with the same set of core issues being included in most training programs. Core areas of training included: the child protection system, assessment, interviewing children, court maers, key child welfare legislation, case management and cultural diversity. Other training areas present in most jurisdictions were dynamics of child abuse and neglect, child development, collaborative practice, out-of-home

care, responding to hostility, resistance, and denial among involuntary clients, as well as worker safety, values and professionalism. It was dicult to make an assessment of the entry-level course content from the module names alone, however from the information available it appeared that Victoria and Western Australian had a stronger emphasis on practice theories and models (e.g., reective practice, strength-based practice) and on specic theories relevant to child protection work (e.g., trauma and aachment). The Victorian training program appears to be targeting higher-level constructs (e.g., departmental values, key skills and aributes) that underlie practice skills. Training programs in every state and territory made specic reference to working with Aboriginal and/or Torres Strait Islander peoples. However, general cultural diversity programs were only provided in New South Wales, South Australia, and Western Australia. In all states and territories, the cultural awareness program regarding Aboriginal and Torres Strait Islander culture was mandatory for all sta across all job titles. Modules on common risk factors such as domestic violence, substance use and mental illness were common characteristics of training programs. It is clear when comparing jurisdictions that signicant duplication in relation to the development of programs has occurred (and continues to do so). Such duplication demonstrates the need for national comparisons such as this one

and the benets of information sharing forums such as the Australasian Statutory Child Protection Learning and Development group.

ASSESSING WHETHER THE AIMS OF ENTRY-LEVEL TRAINING HAVE BEEN ACHIEVED

Statutory child protection learning and development units reported that the aim of entry-level training is to develop in new sta the knowledge, skills and abilities that are required for child protection work; but, how do the learning and development units determine whether or not they have achieved this goal? There are two elements to determining the success of entry-level training programs in achieving their goals. First, if the skills and knowledge taught in training are those that are requisite to the successful performance of the role of statutory child protection worker, then trainees need to be assessed to determine whether they have acquired the minimum level skills and knowledge to perform their role. Second, the training program itself needs to be evaluated to determine whether or not it is an eective program and achieves its aim of developing in new sta the knowledge, skills and abilities that are required for child protection work.

64

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

65

Table 4. Comparison of modules included in entry-level training programs ACT

1. Orientation 2. Mandatory Reporting/ Identifying physical injury and physical effects of neglect 3. Risk Assessment 4. Collaborative Practice 5. Overview of the Children and Young People Act 6. Other Laws relevant to children and Young People in the ACT 7. Annual reviews 8. Emergency Action 9. Writing Afdavits and Giving Evidence 10. Interviewing children and young people 11. Administrative Law 12. Record Keeping 13. CHYPS (data system) 14. Domestic Violence 15. Effective Practice with Involuntary Clients 16. Dealing with Aggressive Clients 17. Indigenous Cross Cultural Training 18. Working with Children in Out of Home Care 19. Looking After Children (LAC)

New South Wales

1. Introduction to the Caseworker Development Course 2. Child Protection Dynamics 3. Case Management 4. Legal Responsibilities 5. Legal Issues 6. Assessing Risk of Harm 7. Alcohol and Other Drugs 8. Mental Health and Child Protection 9. Dual Diagnosis 10. Domestic Violence 11. Building Effective Relationships With Children, Young People and Carers 12. Afdavit Writing and Recording Evidence 13. Interviewing Children and Gathering Evidence 14. Out-of-Home Care 15. Cultural Awareness Day 16. Working with Aboriginal Children and Families 17. Participation in Case Planning

Northern Territory
1. Introduction to Statutory Welfare Work 2. Dynamics of Child Maltreatment Child Abuse and Neglect in the NT Context 3. Aboriginal Cultural Awareness Program 4. Intake 5. Planning the Investigation 6. Danger Assessment 7. Risk Assessment 8. Medical Assessment 9. Legislation - The Community Welfare Act 1983 10. Court Matters overview 11. Role and Support of Foster Carers 12. Young People in Care and Participation 13. Protocols with Police 14. Interviewing Children overview 15. Sexual Assault Referral Centre presentation 16. Managing Client Aggression 17. Training and Supervision. 1. 2. 3. 4. 5. 6. 7. 8.

Queensland
Information Systems Interacting with Children Understanding Young People Intake and Risk Assessment Investigation and Assessment Child Safety Case Management Managing the Care of Children and Young People in Placement 9. Managing Complex Client Needs 10. Apply Knowledge of Government Processes 11. Overview of Child Protection - Care for Babies 12. Child Safety Ofcer Role and Responsibilities 13. Workplace Health and Safety 14. Non-violent Crisis Intervention Training 15. Communication Skills 16. Working with Families 17. Cultural Awareness 18. Court Work 19. Work with Other Services 20. Work in a Legal and Ethical Context

South Australia
1. The following topics are available for all new social workers to book into with the expectation that this could occur over a period of about 2 years: 2. Induction (not competency based nor assessed) 3. Receive and Record a Child Protection Notication 4. Orientation to Child Protection and Out of Home Care 5. Child Protection Investigation & Assessment 6. Case Management & Service Delivery including data management 7. Specialist Communication & Teamwork skills 8. Operate in a Legal Context 9. Work Safely (still being developed but looking at workplace violence and vicarious trauma) 10. Drug & Alcohol Awareness 11. Aboriginal Cultural Sensitivity & Respect 12. Multicultural Diversity 13. Family Care Meetings 14. Provide Support to children affected by Domestic Violence 15. Orientation to disability work 16. Mental Health Awareness 17. Behaviour Management of young people 18. Youth Justice 19. Work in a legal and ethical environment 20. Support the progress and development of young people 21. Working with children - child development 1. 2. 3. 4.

Tasmania
Vision and Values Induction Package Code of Conduct Translating Principles into Practice 5. Supervision Guidelines for Professional Staff 6. Working in Partnership 7. Working with Children and Young People 8. Working in a Statutory Organisation 9. Working with Involuntary Clients 10. FOI Guidelines 11. Privacy and Condentiality Guidelines 12. Client Assessment and Service Document (CASD) 13. Placing Children away from Home 14. Initial Contact and Subsequent Pathways 15. Legal Practice 16. Assessment and Short Term Intervention 17. Tasmanian Risk Framework 18. Electronic Information Tool for Recording Notications 19. Case Management Framework 20. Decision Making 21. Looking after Children 22. Placement of Children

Victoria
1. Each of the three Practice Clinics has a different theme. Practice Clinic One: Organisational Context and the Professional Practitioner, which includes: Introduction to the Learning Materials (Learning Guide, e learning program) 2. Adult Learning principles 3. Developing reective practice 4. Personal values and attitudes 5. Departmental values 6. Key skills and attributes for the Child Protection role 7. The Victorian Risk Framework 8. Information systems and management 9. Working with indigenous children and families 10. Using supervision 11. Management of self and workplace health and safety 12. and Looking After Children. Practice Clinic Two: Child Protection Practice and Process, which includes: Attachment and Trauma theory 13. SIDS and safe sleeping 14. Child Development 15. Frameworks for interviewing children 16. Initial Investigations 17. Working in Partnership with families 18. Working with client complexity 19. Working with involuntary clients 20. Change, resistance and motivation 21. and Case Planning. Practice Clinic Three: Orientation to Court Legal Practice, which includes: Orientation to Childrens Court and Court Advisory Unit processes 22. Court information management 23. Court report writing 24. Preparing children and families for Court 25. Preparing professionals for Court 26. Giving evidence in the Childrens Court.

Western Australia
1. Organisation and its Philosophy 2. Strengths Based Philosophy 3. What guides Your Practice and Ethical Decision Making from a Strengths Based Perspective 4. Legislative Framework 5. Cultural Diversity 6. Working with Aboriginal Families 7. Overview of Protection of Children 8. Early Brain Development 9. Attachment and Bonding 10. Identifying Child Abuse 11. Intake, Classication and Response 12. Undertaking an Investigation 13. Finalising an Investigation 14. Child Safety Assessment Framework 15. Interviewing Children 16. Workplace Health and Safety Worker Safety 17. Court Proceedings 18. Information systems 19. Overview of Children in Care 20. Voice of the Child 21. Relative Carer Assessment Framework 22. Resourcing Children in Care 23. Voice of the Foster Carer/ Voice of the Caseworker/ Voice of Placement Agencies 24. Abuse in Care.

66

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

67

ASSESSING COMPETENCE OF ENTRYLEVEL TRAINEES

Assessment is conducted to determine if an individual can perform the skills or tasks required to do a job. The key aim of assessment is to predict future performance. Assessment processes and the consequences for failing assessment vary across jurisdictions. Trainees participate in a combination of classroom/competency assessments, role plays, wrien assessments and examinations. Assessment is not linked to employment status in any jurisdiction, except Queensland (see Table 5). Table 5. Assessing competence of entry-level trainees
How are training participants assessed? ACT NSW NT QLD There is no workplace assessment of the Core Training.

ROLE OF SUPERVISORS IN SUPPORTING AND ASSESSING ENTRY-LEVEL TRAINEES

In all jurisdictions, supervisors are involved in supporting new sta in the workplace. New sta may also seek support from experienced sta in two main ways. In many jurisdictions there are designated Senior Practitioners whom practitioners are encouraged to consult. In other jurisdictions workers are buddied with a more experienced worker. In New South Wales and Victoria supervisors are provided with a kit or guide to assist them in the support and supervision of new workers.

In New South Wales and Queensland, supervisors are directly involved with the assessment of new sta. In New South Wales, supervisors have to complete the Caseworker Assessment Report within six weeks of completing entry-level training. These reports are submied to the learning and development branch. If there are any identied skills gaps at this point a development plan may be made with the worker, supervisor and the learning and development branch to address the identied skills gaps. In Queensland, on completion of entry-level training Child Safety Ocers must complete a Workplace Assessment workbook that has seventeen core competencies. Some of these competencies are mandatory and some of the competencies are role or job specic. These competencies need to be completed over a 12-month period. The Workplace Assessment workbook must be signed-o by workplace supervisors and the centre Manager.

DISCUSSION
The aim of this study was to provide a national snapshot of the way in which training in child protection is being provided at a point in time (October 2005 March 2006). Although a detailed critique was not provided, there are several broad issues that arise from this description of training in statutory child protection services in Australia. In a study comparing Australian statutory child protection services, Bromeld and Higgins (2005) concluded that while there were dierences in the procedures and legislation guiding the provision of services, there was a large degree of similarity in the core activities being undertaken by child protection practitioners (e.g. information gathering, assessment, case planning and case management). This nding was supported by the ndings of this audit of Australia statutory child protection training. There was very lile dierence in the broader purpose of learning and development units, or the specic aims of entry-level training across jurisdictions. All training was mapped to some extent to all of the national competencies, thus it is not surprising that the content of training programs (in terms of the topic areas included) were very similar across jurisdictions. There was also very lile dierence in the entry-level qualication requirements for statutory child protection workers across Australia. Although the aims and content of entry-level training were very similar, the structure in entrylevel training varied signicantly across jurisdictions in terms of when training began, the total duration of the training period, length of training blocks, and the role and length of workplace learning in the training process. The greatest area of variation was the size of training units. The number of dedicated child protection trainers ranged from two to 29. A variety of factors combined to explain dierences in the size of training units such that the conclusion drawn was that size of training units was not directly comparable across jurisdictions. The size of training units and the resources available in terms of stang are likely to have also impacted the structure of entry-level training.

What are the consequences of failing assessment? n/a

A combination of classroom assessment where assessors complete Re-sit assessment and/or develop plan for future focus of agreed criteria, role plays and examinations. development. There is no formal assessment process for core FACS training. All n/a commencing staff are placed on a three month probationary period. A combination of practical competency based assessment (such as Participants are able to re-sit the rst assessment visits to a house that is used as part of the Training Branch to practice on two occasions and then once for all other pieces of investigation and assessment) and exams. assessment. A failure to be deemed competent after this results in termination of probationary period. A mixture of assessed activities in training, assignments to be completed Assessment is not linked to employment status. Trainees after training which could be workplace projects or production of who do not meet assessment standards are encouraged particular reports etc and observed workplace activity. Assessment is to try again. not compulsory, individuals make this choice. Child Protection Services is developing an assessment process for people Probation periods apply to all new permanent employees who participate in training. and xed-term employees where the appointment is for a period of six months or more. The purpose of a probationary period is to ascertain whether the work performance and conduct of a new employee meets the standards expected in the State Service. It is therefore important that all new employees participate in an induction and orientation program and receive relevant training and feedback on their performance. If there is concern about any aspect of the probationers work performance, remedial action such as counselling, closer supervision or further training is provided. In situations where serious performance problems arise, employment may be terminated. Three assessments are conducted in the Beginning practice program: writing a safety statement (risk assessment); engaging a parent on a rst visit; and giving evidence in court. These are assessed by the submission of written material by participants, or the observation of skill demonstrated in a training room environment. Training consultants assess by providing written feedback to the participant with a copy provided to the workplace-based supervisor. Feedback is provided to the region for regional management to manage on-going performance and learning and development needs. This is specic feedback in relation to core capabilities, however does not seek to assess as competent or not yet competent. Where practice concerns are identied in the course of the Beginning Practice program, the training consultant will engage in an open and transparent process, providing specic feedback to the new recruit and to their workplace-based supervisor.

THE EFFECTIVENESS OF STATUTORY CHILD PROTECTION TRAINING PROGRAMS

Assessment processes for trainees provides a means to determine how eective an individual has been in acquiring the knowledge and skills that training is designed to impart upon them. However evaluation is needed to determine how eective the training program is in conveying these knowledge and skills. For example, if an entire cohort fails to meet an assessment standard is this most likely due to individual failure or the quality of the training? For a discussion on evaluation see (For a discussion on evaluation see Holzer, J. Higgins, Bromeld, Richardson & D. Higgins, 2006). In Australia, only Queensland and Victoria have had their entry-level training programs formally evaluated to determine their eectiveness. While the results of these evaluations were reportedly positive, the evaluations are not readily available to the public. However, all other jurisdictions with training programs in place incorporate multiple forms of internal evaluation including, participant feedback, training advisory groups, trainer and supervisor feedback and analysis of assessment results.

SA

TAS

VIC

WA

Western Australia do not assess whether learners are considered to be n/a competent or not. However, sessions, days and courses are evaluated through participant observation, survey forms, case scenarios, role plays and group assessments.

68

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

69

Processes in place for recognition of prior learning, and even the position adopted in relation to the favourability of recognition of prior learning, varied between jurisdictions. Only half of the Australian jurisdictions had formal assessment processes in place to determine whether trainees had actually acquired the requisite skills to successfully undertake the position of statutory child protection worker at the completion of training. Where formal assessment processes were in place, assessment was only linked to employment status in one jurisdiction. Only two jurisdictions had formally evaluated their training programs to determine whether they were eective in achieving their goals. The apparent lack of aention to assessment and evaluation are consistent with other areas in child welfare. In an audit of Australian child abuse prevention programs, Tomison and Poole (2000) reported that the majority of Australian programs had not been subjected to anything beyond process and input evaluation that is, they had not been evaluated to determine whether or not they worked. There is a need for training programs to be evaluated to determine the eectiveness of these programs in preparing individuals for the role of child protection practitioner. In the opinion of the authors, evaluation and assessment of sta training are important steps to ensuring children and families receive quality service provision. However, even with adequate evaluation and assessment to ensure quality training is in place, training alone cannot guarantee that service standards will be reached or prevent all potential errors in decision-making. Training is important, but it is not the solution to everything. With the increasing levels of accountability and public scrutiny in the area of child abuse intervention the importance of targeted and eective training has never been more critical. In all states and territories, reviews of the deaths of children known to child protection agencies and reports from various inquiries have identiedthe need for reform in the areas of induction, training and ongoing professional development of sta (Forster, 2004). Despite such recommendations, there is still evidence to indicate that traditional training methodologies do not always work and that the best models include a combination of targeted recruitment and selection, timely induction

and entry level training and ongoing support and supervision in the eld (Gibbs, 2001; Oce of Public Service Merit and Equity (OPSME), 2005; OgilvieWhyte, 2006). The limitation of this paper is that it provides a description only of statutory child protection training programs in Australia. We have not engaged in any discussion in relation to what constitutes good training. In addition, this is not a study of training participants or trainers actual experience of training, rather it describes the policy and procedure framework that guides the way in which training is designed to be provided. Australian research that examines child protection workers sense of preparedness for their roles, and how this links to the training that they receive may be of benet. The ndings from this paper have signicant implications for policy makers and trainers. The paper provides trainers with sucient information to enable them to identify other jurisdictions they may approach in relation to the development of new training materials in a specic area. The high degree of similarity between jurisdictions also supports the assumption of the Australasian Statutory Child Protection Learning and Development Group that trainers can benet from sharing resources and learning from the experiences of trainers in other jurisdictions. Arrangements have been made in the past for workers in one jurisdiction to sit in on training provided by another jurisdiction. This is particularly the case with smaller jurisdictions sending their sta to training programs run by jurisdictions with larger training programs. In the past, this has happened on an ad hoc basis. However, the purchasing of training places from another jurisdiction may be able to be developed as a planned response and in some cases may be more economical than developing and running the programs in-house. The ndings from this paper also support the notion that there is a base set of skills that are consistent across jurisdictions, and which new sta are trained in by state and territory statutory child protection learning and development units. Therefore it is also likely that skills and knowledge gained in

one jurisdiction may be transportable to other jurisdictions. One of the possible future functions of the Australasian Statutory Child Protection Learning and Development group could be to identify skills clusters that are recognisable across state and territory borders. Such an initiative would make transportability of skills, recognition of prior learning and current competencies easier across Australia. In turn, this would have ow-on benets in terms of nancial savings and a reduction in duplication of training. The identication of skills clusters recognised across jurisdictions would be a signicant means of progressing a national approach to child protection in Australia. National approaches in the child protection eld is an apparent priority for Commonwealth, states and territories demonstrated by the establishment of the Community and Disability Services Ministers Advisory Council National Approach for Child Protection Working Group. While the Australasian Statutory Child Protection Learning and Development Group may be able to identify common skills clusters, recognition of such clusters across borders would need to be coordinated across training and policy divisions within state and territory departments. One of the issues preventing such recognition at the moment is lack of formal assessment procedures across Australian jurisdictions. Assessment processes that were recognised under the Australian Qualications Framework (as is the case in South Australia) would assist to overcome this diculty. The ndings from this paper may also be of interest to practitioners, community-based child welfare organisations, and academics (in relation to both research and course content). In particular, practitioners may be interested to know about training processes in other jurisdictions, and at a more practical level may use the ndings from this paper to make informed decisions about career development that involves moving across jurisdictional borders or to inform applications for recognition of prior learning. Like smaller jurisdictions, communitybased child welfare organisations may not have the resources to develop their own training programs and may nd it more economical to negotiate purchasing training places in specic statutory

child protection training modules. This paper also increases the awareness among all readers of the knowledge and skills expected of statutory child protection workers.

CONCLUSION
Although there were dierences in the procedures and frameworks for the provision of training, the aims and content of statutory child protection training across Australian jurisdictions was more similar than dierent. The ndings from this study suggest that there are great opportunities for the sharing of information across jurisdictions, and that training programs are suciently comparable for resources to be incorporated from other states and territories with only minor modications to account for local issues. Issues in relation to assessment and evaluation are priority areas for future research.

REFERENCES
Adams, R., Dominelli, L., & Payne, M. (2002) Social Work: Themes, Issues and Critical Debates. (2nd ed.) Basingstoke, UK., Palgrave in association with The Open University. Alford, J. (1997) Towards a new public management model: Beyond managerialism and its critics, in Considine, M. and Painter, M. (eds), Managerialism: The Great Debate, Melbourne, Melbourne University Press, 152-72. Calvert G., Ford A., & Parkinson P. (eds) (1992) The Practice of Child Protection Australian Approaches. Sydney, Hale & Iremonger, Suthwood Press. Charles, M. & Wilton, J. (2004) Creativity and Constraint in Child Welfare in Lybery, M. & Butler, S. (eds.) Social Work Ideals and Practice Realities. New York, Palgrave MacMillan (179-199). Forde, L. (1999) Commission of Inquiry into Abuse of Children in Queensland Institutions. Report. Brisbane, Queensland Department of Families, Youth and Community Care. Gibbs, J. A. (2001) Maintaining Front-Line Workers in Child Protection: A Case for Refocusing Supervision, Child Abuse Review,10, 323-335.

70

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 6

71

ARTICLE
Gursansky, D., Harvey, J. & Kennedy, R., (2003) Case Management: policy, practice and professional business. Crows Nest, N.S.W., Allen & Unwin. Hough, G. Enacting Critical Social Work in Public Welfare Contexts in Allan, J., Pease, B. & Briskman, L. (2003) Critical Social Work: An Introduction to Theories & Practices. (Chapter 14) Crows Nest, N.S.W., Allen& Unwin. Jones, D. (2004) Geing the Best for Children. Lectures in Australia for the Early Childhood Foundation. Canberra, September. Kadushin, A. (1976) Supervision in Social Work, New York, Columbia University Press. Lewis, S. (1998) Educational and organisatioinal contexts of professional supervision in the 1990s. Australian Social Work, 51(3), September, 31-39. Lishman, J., in Campling, J. (2002) Social Work: Themes Issues and Critical Debates Basingstoke, U.K., Palgrave in association with The Open University. Lonne, B. & Thomson, J. (2005) Critical review of Queenslands Crime and Misconduct Commission inquiry into abuse of children in foster care: Social works contribution to reform. Australian Social Work, 58(1), March, Meagher, G. & Parton, N. (2004) Modernising Social Work and the Ethics of Care. Social Work and Society. 2(1) Murray, G., (2004) The Territorys Children: Ensuring safety and quality care for children and young people. Report on the Audit and Case Review. Canberra, ACT, Commissioner for Public Administration. July. Parton, N. (2004) Maria Colwell to Victoria Climbie: Reections on Public Inquiries into Child Abuse a Generation Apart. Child Abuse Review 13, 80-94. Pecora P., Whiacker J., Maluccio A., & Barth R., (2000) The Child Welfare Challenge ePolicy, Practice & Research (2nd ed.) New York, Aldine de Gruyter. Powell, D. (2004) Clinical Supervision in Alcohol and Drug Abuse Counselling. San Francisco, Jossey Bass. Stanley, N. & Manthorpe, J. (2004) The Age of Inquiry Learning and blaming in health and social care London, Routledge, Taylor & Francis Group Marilyn McHugh PhD Research Scholar Social Policy Research Centre University of New South Wales Sydney NSW 2052 Phone: +61 2 9385 7800 Fax: +61 2 9385 7838 E-mail: M.McHugh@unsw.edu.au Trevithick, P. (2003) Eective relationship-based practice: a theoretical exploration Journal of Social Work Practice, 17(2).

THE CHILD PROTECTION REVIEWS

Layton, R. QC (2003) Our Best Investment: A State Plan to Protect and Advance the Interests of Children. Adelaide, South Australian Department of Human Services. Queensland. Crime and Misconduct Commission (2004) Protecting Children: An inquiry into the Abuse of Children in Foster Care. Brisbane, Queensland Crime and Misconduct Commission. Chairperson: B. Butler SC. Vardon, C. (2004) The Territory As Parent: Review of the Safety of Children in Care in the ACT and of ACT Child Protection Management. Canberra, ACT, Commissioner for Public Administration.

Indirect Costs of Fostering and their Impact on Carers

Marilyn McHugh
ABSTRACT
In Australia, volunteer foster carers receive a subsidy (allowance) to assist in meeting the direct costs of fostered children. Most foster care programs assume the services of the carer usually the mother are essentially free or no cost items. Preliminary analysis of a study with a sample of foster carers indicates that carers incur a signicant number of indirect costs including: opportunity costs in foregone earnings; time costs from primary care work and the emotional/psychological costs of caring. In light of the diculty in recruiting and retaining foster carers and the increase in the number of children and young people with challenging behaviours requiring foster care, a key question for policy makers arises. Can generalist fostering services continue to be maintained in Australia on a volunteer basis or should carers receive a payment (e.g. fee/salary/wage) as reward or compensation for caring? The concept of paying foster carers is complex and controversial. The controversy arises due to the nature of caring work which overlaps activities performed out of love (or altruism) with those performed for money and the motivation underlying caring labour. The paper presents the perceptions of interviewed foster carers and discusses some policy issues.

INTRODUCTION
In Australia, the main provision of out-of-home care (OOHC) services for children who can no longer live at home with their parents is foster care (57%) and relative (or kinship) care (42%). In most Australian States and Territories1 the number of children placed with foster carers is declining while the numbers placed with kin or relatives is increasing, though the numbers in each type of care is highly variable between the States (AIHW, 2006)2. Very lile use (3%) is made of residential care in Australia (ACWA, 2006). At June 30, 2005 there were 23,695 children in OOHC. In the last 20 years the OOHC population has increased from around 14,000 to 23,700, an increase of 70 per cent. While Indigenous people comprise only 2 per cent of the total population, Indigenous children make up 20 per cent of the OOHC population (AIHW, 2006).
1 For ease of discussion States and Territories will henceforth be referred to as States. 2 The term children includes children and young people. 73

72

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

All Australian States administer similar programs for children in OOHC. Placements are managed either by a statutory authority: a government department or by non-government agencies. In Australia non-related foster carers are volunteers. They are provided with an age-related subsidy that varies between age groups of fostered children and levels of allowance from State to State. Most States provide foster carers with higher (enhanced) levels of subsidy to cover the cost of children with special needs. Small numbers of foster care programs in Australia, oen run by non-government agencies for hard to place children, reimburse carers with signicantly more than is provided to most generalist carers. The amounts of these payments are closer to the level of a wage or salary than just reimbursements for costs. It is not unusual for these agencies to require one carer to be at home at all times.

young people with highly complex needs entering the care system. With a reduced pool of carers to draw upon for an appropriate match between foster child and carer, the risk of multiple placement breakdowns is heightened. (Barber, Delfabbro and Cooper, 2001; McHugh et al., 2004). Several factors contribute to the diculty in aracting potential foster carers. One is the signicant increase in labour force participation of married mothers, once the typical foster carer. The marked increase in womens labour force participation reects: womens higher education standards and career aspirations; changing societal aitudes towards the role of women; the economic necessity for many women to support themselves and/or to contribute to household income; and with rising longevity the increasing need by women to secure an adequate income in retirement (McDonald, 2001; Thompson, 1999). Postponement of parenthood and rising longevity means that many women in their middle years (40+) caring for their own children, and with responsibility for ageing parents, are unavailable to be foster carers. A further diculty in aracting people is that potential carers must have the motivation and the capacity to care: they need to be nancially, emotionally, mentally and physically secure; have adequate space for a child; have appropriate parenting ability and be knowledgeable about child rearing (Colton and Williams, 2006: 113). As a consequence of these numerous factors the pool of women from which to recruit foster carers has diminished. Although the level of demand for carers in NSW is unknown workers in some areas struggle to nd appropriate placements for children, particularly teenagers, and have diculty in aracting potential carers. Reecting the demanding nature of foster caring research studies in the US indicate that considerable numbers of potential carers drop out before training is nished and more leave within the rst 12 months (Jarmon et al., 2000; Moller, 2003; Rhodes et al., 2003; Rhodes, Orme and Buehler, 2001;). In addition to the diculty in recruiting carers is the perception that children requiring placements are posing greater diculties for carers. The rise

in the number of foster children with challenging behaviours and complex needs is one of the greatest concerns in OOHC. This problem is not specic to Australia with recent national and international studies noting the increasing complexity of behaviours of foster children. Studies report aggression, sexualised behaviours, delinquency, emotional disturbance, developmental delay and disabilities, drug and alcohol use/addiction in older foster children and drug and alcohol aected babies in care (Jarmon et al., 2000; Sellick, 1999; Wise, 1999; Sultmann and Testro, 2001; Triseliotis, Borland and Hill, 2000; Vic, DHS, 2003). The complexity of foster childrens needs is thought to reect greater rates of family breakdown, parental drug and alcohol abuse, family violence and parents mental health issues. Many studies reveal that children are coming into care later aer longstanding experiences of signicant abuse and chronic neglect. Later entry appears at times to be the result of early intervention and support programs that have failed to ameliorate abuse/neglect of children in some dysfunctional families. With the demise of residential care in Australia children with challenging behaviours and complex needs, who might benet from therapeutic residential care or treatment foster care, are posing insurmountable problems for general foster carers oen resulting in multiple placement breakdown (Barber, Delfabbro and Cooper, 2001; DHS, 2003; Hillian, 2006; McHugh, 2004 et al).

Carer age: It appears that the age prole of foster mothers has increased both in Australia and elsewhere, a trend consistent with delayed family formation for the general population of mothers. A 1986 study of NSW foster carers found most female carers in the age group 25-49 years (Gain, Ross and Fogg, 1987). Two more recent studies indicate that most female carers were aged 35-54 years (McHugh et al., 2004) or were in the age band of 45-54, with 20 per cent over the age of 54 (AFCA, 2001: 76). The relatively older average age for female carers found in Australia is similar to ndings in four UK studies (Collis and Butler, 2003; Kirkton, Beecham and Ogilvie, 2003; Sinclair, Wilson and Gibbs, 2004; Triseliotis, Borland and Hill, 2000). Carer Employment: Female carers are not usually in paid work. If employed they are more likely to work part-time. Several studies have found around one-third to two hs of female foster carers work part-time while fostering (Kirkton, Beecham and Ogilvie, 2003; McHugh et al., 2004; Sinclair, Wilson and Gibbs, 2004; Triseliotis, Borland and Hill, 2000). The employment rate of female foster carers suggests that the nature and demands of providing a fostering service negates the possibility of fulltime involvement in paid work. Carers with no involvement in paid work may well have chosen to be at home because they believe this is best for foster (and own) children or they may have already exited the paid work system (e.g. on age pension). A further reason for non-employment of foster mothers is due to some fostering agencies preferring or requiring one partner (of a married couple) or the sole carer not to be in paid employment. Some fostering schemes in the UK also operate with full-time carers (Sinclair, Wilson and Gibbs, 2004). Household Income: There lile data on carer incomes in Australian studies. The available evidence suggests that in general most foster carers are in receipt of modest household incomes including signicant numbers on income support payments (CMC, 2003; Evans and Tierney, 1995; CMC 2003; McHugh et al., 2004; Thorpe 2006). Foster carer role. Carers in the 21st century are required to be more experienced, skilled and resourceful for the arduous and time consuming tasks and activities
75

FOSTER CARE IN CRISIS?

A number of major reports on OOHC in Australia, in recent years, have stressed that the provision of home based care (foster care) is in a state of crisis and urgent reform is required (CAFWAA, 2002; Carter, 2002; PeakCare, 2002; NSW, SCSI, 2002; Semple et al., 2002). The perceived crisis in foster care is not specic to Australia - it is a recurring theme in the empirical literature on fostering throughout developed and developing countries (Colton and Williams, 2006). The nature of the crisis in Australia is multi-faceted, but it appears to be due to outdated policies and practices, inadequate resources and a shortage of paid workers and volunteer carers. State governments have responded to the crisis with proposed reforms and increased resources of money and sta. For example, in NSW, the Department of Community Services (DoCS) and non-government fostering agencies are undertaking a series of reforms in their policies and programs. In 2002, the NSW Government pledged $1.2 billion, over a six year period to strengthen the child protection and out of home care systems (DoCS, 2004). Two crucial factors surface time and again in relation to the systemic crisis: the decreasing number of people volunteering to be foster carers with the retention of carers also problematic. The second factor is the increase in the number of children and
74

CHANGING FACE AND ROLE OF AUSTRALIAN FOSTER CARERS

Evidence from numerous surveys both nationally and internationally indicates that women, usually married mothers, form the majority of foster carers. However, reecting the general rise in single femaleheaded families in society, the number of single female carer foster families is increasing (Collis and Butler, 2003; Kirkton, Beecham and Ogilvie, 2003; Sinclair, Wilson and Gibbs, 2004; Triseliotis, Borland and Hill, 2000). A survey of carers (n=450) in NSW in 2003 found single female foster carers represented around one-quarter of all foster families compared to just 14 per cent in 1986 (McHugh et al., 2004).

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

of fostering. Once initial training was sucient to be a foster carer. Regular, ongoing training is now becoming a more critical element in fostering. In NSW, for example, the new role of foster caring can also include the involvement of carers in carer assessment and training and support groups and experienced carers mentoring new carers (McHugh et al., 2004). The changed nature of fostering has meant that there is a general trend, particularly among longer-term carers, to see their current fostering role as more professional. The increasing professionalism of carers is evidenced in a recent NSW carer survey. The survey (n=450) found that most carers (86%) thought fostering should be either semi-professional (54%) or professional (32%) compared to 13 per cent who thought it should be voluntary. The longer carers had fostered the more likely they were to see the current and future role of fostering as professional work (McHugh, 2004). Other Australian studies reecting on the increasing professionalism of foster carers note the need for more specialist training and further carer skills development (Butcher, 2004a, b; Thorpe, 2004). International developments: Three countries, the UK, France and Sweden, are already far in advance of Australia in nancially supporting their foster carers. Foster carers in the UK receive an allowance (subsidy) to cover the cost of caring for a child in their home. Foster caring is seen as a professional role and many local authorities, voluntary and independent fostering agencies run schemes that pay foster carers a fee in addition to the subsidy payment. The fee may be linked to the childs particular needs but is oen based on a carers skills, abilities, length of experience or professional expertise. The introduction of tax relief (2003) means that foster carers earning up to a maximum of 10,000 plus allowances do not pay tax on their fostering income (BAAF, 2006). National Insurance is paid for all foster carers providing them with a pension when they retire (van Sloten, 2006) Legislation has granted foster carers professional status in France. Professional training is compulsory, amounting to 120 hours for the rst three years (40 hours per year) and carers receive payment for training. Child care for fostered children is provided
76

whilst carer training takes place. Contracts are drawn up for each placement; professional monitoring of carers is in place and foster carers are consulted about any decision relating to the foster child in their care. In relation to nancial support carers are paid a wage that is guaranteed for temporary absences of the foster child and additional money is paid for the childs keep. When the child leaves payment for the child ceases. The wage component however, continues for three months if another child is not placed with the carer (Corbillion, 2006). In Sweden carers also receive a fee for the work they do in addition to an allowance for the foster childs board and lodgings. If a carer is required to stay at home due to the childs special needs the fee component is doubled as compensation for lost employment income (Hojer, 2006). Other countries, for example, the USA and Poland oer reimbursements to generalist carers to cover the costs of a fostered child (van Sloten, 2006, Wehrmann, Unrau and Martin, 2006). Both countries however, do have specialist, treatment or professional fostering programs which pay carers a salary on top of their allocation for the costs of the children (Barbell and Wright, 1999; Dore and Mullin, 2006; James and Meezan, 2000; Testa and Rolock, 1999; van Sloten 2006). In Australia the notion of paying foster carers for the work they do has also been explored by other writers (Smith, 1988, Smith and Smith, 1990). In light of the changes in the type of children coming into care and the changing role of carers in Australia it appears an opportune time to consider whether, in aracting, supporting and retaining carers, consideration needs to be given to increasing the remuneration for foster carers. A carer payment (e.g. fee, wage or salary) in addition to an allowance for a foster childs costs could serve a number of functions. A carer payment could assist with the recruitment and encourage families who need additional income from a mothers paid work to foster. People with previous qualications prepared to take on the role of foster caring may have the required skills to care for the increasing number of foster children with high and special needs and be recompensed for their particular skills.

A carer payment as part of a package would recognise carer skills, expertise and commitment. Increased professionalism would encourage more experienced carers to be involved in carer training and support of other carers and depending on their level of involvement/ expertise be reimbursed for these extra tasks. A carer payment would assist with covering a carers indirect costs, i.e. the emotional/ psychological, time and opportunity costs (i.e. lost income from paid work) of caring

for carers. 2. Initial and ongoing motivation in providing a fostering service. 3. Carers perceptions of the indirect costs of caring: emotional costs; time costs and the earnings foregone (opportunity costs). 4. Proposal of a wage or salary as a reward (compensation) for fostering. Oldelds framework for examining the time costs of foster carers was adapted and used in the interviews with the NSW carers (Oldeld, 1997). Using the model the research examined how much extra time the main carer, usually foster mothers, estimated it took in a number of fostering tasks and activities. The areas where time costs with foster children were explored included the following: personal care (e.g. meal, bath and bed time); general household activities (e.g. cleaning, laundry, maintenance and repairs); travel; therapeutic activities (e.g. therapies, school, homework, play and sport); administration of the foster care placement (e.g. meetings and paper work); emotional support (e.g. developing relationships, dealing with adjustments and counselling); other less frequent or one-o tasks/activities (e.g. carer support groups and training). Complementing the analysis of the extra time taken for fosterings tasks and activities was data from Australian Time Use Survey (Ironmonger, 2004, Craig, 2006). This data was used to illustrate the time it takes to care for children not in care (author emphasis). The next section of the paper briey describes the emotional/psychological and time costs involved in foster caring. In understanding how carers perceived the opportunity costs of fostering they were asked a number of questions about paid work and what they might be doing if they werent fostering (e.g. jobs, voluntary or leisure activities). The last section of the paper focuses on carers views of their opportunity costs (foregone earnings) and their perceptions of being paid to foster. The discussion on payments (i.e. wage/salary) revealed a number of contradictions

METHODOLOGY
The remainder of this paper is based on a study on fosterings indirect costs. The study consisted of indepth qualitative interviews with 30 foster mothers (20 non-Indigenous and 10 Indigenous) conducted in and around Sydney, NSW in 20053. It followed an earlier project by the writer on estimating the direct costs to carers of providing a foster care service (McHugh, 2002). Carer prole: The average age of the 30 female carers was 50 and most were married (n=21). The main source of income for 15 carers was the male partners salary or wage. Fieen carers (couples & singles) were reliant on government income support. Eight carers were in part-time employment as book keepers (for self-employed husbands), data entry operators and in sales. Three of the eight were professionals, an obstetric nurse, a training consultant and a teacher. Most carers were experienced carers with two-thirds (n=20) of the carers fostering between ve and 23 years. Over a half had fostered between 32 to 150 children. At the time of interview the 30 carers were caring for 76 foster children. The indirect costs study utilised three UK studies exploring carer motivation and remuneration and the indirect costs of fostering (Kirkton 2001; Kirkton, Beecham and Oglivie 2003; Oldeld 1997). Questions in the interviews with all carers covered the following topics: 1. Perceptions of carer role. Changes to the role over time. Positives and negatives of fostering
3 The paper is based on the authors PhD study. Ethics clearance to interview carers was granted by the Ethics Commiee of the University of New South Wales.

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

77

that arise for carers in discussing issues around love (or altruism) and money in relation to foster caring. Overall there was lile dierence between the responses of Indigenous or non-Indigenous women in relation to the indirect costs of fostering.

some challenging foster children drew their family together. Some carers went to extraordinary lengths to maintain contact with foster childrens birth family members while others, oen for safety reasons, had lile contact with birth families. Time costs of fostering: The interviews with carers revealed that the time costs of fostering were qualitatively dierent from the care of non-fostered children. The gures in Table 1 indicate that the extra time required for foster children was substantial, on average around an extra three hours per day. What was evident from the gures on the extra time required for fostered children was that the allocated time did not change signicantly for children in any age group. Fosterings tasks and activities took 2 hours for children 0-4 years and around three to 3 hours for children 5-10 years and 11-16 years respectively Data from the Australian Time Use Survey indicates that women spend on average around 6.5 hours a day in primary and secondary care activities (Craig, 2006; Ironmonger 2004;). In comparison to fosterings time which increases as children grow older the time taken to care (non-fostering) diminishes as children grow more independent, from around eight hours per day for a child aged 0-4 years to just over three hours per day for a child aged 11-16 years (Ironmonger, 2004). Interviewed foster carers noted that a substantial component of the time costs was in the emotional/ psychological support of foster children. For school age, adolescent and teenage children, who were more likely to require ongoing aention, reassurance and consolation, the time spent in emotional support was not only extensive but intensive. The estimates of time indicate that, regardless of

RESULTS
Emotional/psychological costs: An analysis of the carer data found that the maintenance of the relationships underpinning a fostering service result in a number of emotional and psychological costs for carers. For carers these relationships are with: the foster children placed with them; the fostering agency and the agencys case workers; the carers own family and friends; foster childrens birth families. The research examined the positive and negative impact of these relationships on carers. Overall carers were very positive about their fostering experiences. However, for some carers there were oen episodes of acute distress, especially in relation to aachment issues with foster children around placement transitions (e.g. to a permanent placement or reunication with own family). Many carers had diculties with foster childrens caseworkers in resolving issues around the unmet needs (e.g. health and education) of foster children and being respected and valued for the work they do. Other carers reported periods of stress with their spouses/ partners and other family members over fostering. The time demanding nature of some placements led to carers feeling guilty about puing their own family second. Some carers reported their children openly resenting the time carers spent with foster children, while others found solving the problems of

the age of the child, when fosterings extra costs are added to ordinary (non-fostering) day-to day care the time costs for carers are signicant. Hours of care range from 10.6 hours for children 0-4 years down to 6.7 hours for children 11-16 with an overall average of 9.5 hours per day. Carers in the study agreed that the time costs of fostering were higher in the rst few months of placements, as traumatised children sele into new families with new routines, and adapt to new ways of behaving and socialising. For carers providing emergency, respite and short- to mediumterm care time costs were consistently high. Time costs appeared less for carers of children in long-term placements who had been with the carer for some years. For children with high and special needs or disabilities, however, the extra time required to care appeared not to diminish, regardless of the length of the placement. Opportunity Costs: Carers not in employment stated that they could see lile point in having a paid job if it meant paying child care or baby siing fees for foster children. Many carers of school age children, where suspensions and even expulsions were not unusual, mentioned the need to be available in case the school called them. The need to aend ongoing therapies and/or doctors, specialists and hospital appointments for foster children or to be available to do access visits with birth family members precluded any thought of paid work for others. In addition to the demands of fostering most carers, with preschool and school-aged children of their own, said they preferred to be at home. Three carers gave up their paid work aer commencing fostering because they found it too dicult to do both. For carers who worked and fostered geing the balance right was not always easy. For the eight carers who worked (part-time) their ability to combine the two roles of carer/paid worker relied on the willingness of their partners or other relatives to care for foster children while they worked. Those who worked valued their nancial contribution to the household and one carer also thought working foster mothers provided a good role model for foster children to observe. Carers in paid employment were asked what they might do if they had to make a decision between

fostering or paid work. Five were adamant that they would continue fostering. Three carers were more hesitant in their responses. One married carer, a home-based clerical worker, thought if she had no option but to nd paid work she would stop fostering. Two married carers, ages 42 and 51, both working substantial part-time hours in professional occupations (nursing and training) found the question really hard but said, because of mortgage payments, nancially they needed to work and would probably leave fostering. In general most carers appeared cognisant of the opportunity costs of fostering, but except for one carer, none intimated that they were prepared to give up fostering in pursuit of paid work. If not fostering however, two-thirds (20) of the carers said they would be in paid work. The remaining 10 carers, many older, gave a variety of activities that they would be involved in including: holidaying or travelling, volunteering in another capacity or retired. Carers past labour force participation: In discussing their past paid work carers spoke of the good money they had earned and the enjoyable times they had when employed. Many noted that nancially they would be beer o if they had continued working. As a consequence of cuing back to part-time teaching while fostering an older Indigenous carer regreed that she had decreased her superannuation payout. Carers in their late ies to early sixties thought age, lack of skills and work experience would make it dicult for them to get paid work. While the prospect of work may have been enticing for some carers most gave it only cursory consideration. Their comments indicated that the choice they had made to be a foster carer was a denite commitment that would not be changed lightly. They valued their role as carers very highly with one saying: Therere lots of things I would have liked to have done. But you make a commitment. Probably its cost us a bit. Financial Situation: Carers spoke about their nancial situation when they ceased being foster carers. While some were prepared to give the maer some thought they were keen to reiterate that their future nancial situation had no bearing on what they were doing now. If ceasing to foster became a reality the
79

Table 1: Mothers Daily Total Time Spent in Fostering and Other Child Care Time (non-fostering) by Age Group of Child Area
Extra child care time: fostering Child care time (non-fostering) Total time child care

0-4 years
2.5 8.1 10.6

Hours per Day 5-10 years 11-16+ years

2.9 6.8 9.7 3.4 3.3 6.7

All ages
3.0 6.5 9.5

78

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

carers age was an important factor in relation to their nancial situation. Younger age carers were more thoughtful and concerned about what they might do if they ceased fostering. One, aged 42, a midwife working part-time, with two own children approaching high school age had considered the maer. She said she would probably go back to fulltime work. Not having anything to fall back on when she ceased to be a foster carer was of concern to a 35 year old single parent living in rented premises with own and foster children in long-term care: I oen think I have no nest egg for me like super or anything like that, nothing to really full back on, thats why I want to try and get my foot back in the workforce and get some money for myself and for my kids. Older carers who owned their accommodation were not particularly concerned. A few carers said they thought they would be beer o nancially when they ceased fostering. Being paid to foster. In the discussion on work/nances carers responded to the somewhat controversial suggestion that: Foster carers should be treated like other workers in caring occupations i.e. paid employees with all the benets aached to paid work e.g. leave entitlements, superannuation contribution, long service leave, workers compensation, and the payment of income tax. This proved to be a very engaging topic generating robust discussion with all carers as to whether carers saw their role as worthy of some reward or compensation, i.e. a wage or salary. Thirteen carers were adamant that foster carers should not be paid. Seven carers supported the general idea of a carer payment. Ten carers were more ambivalent about a carer payment seeing both positive and negative aspects. In the interviews carers provided both advantageous and disadvantageous aspects of a carer payment. Six carers said they could see no advantages to the payment. Three carers either didnt know or were not sure of any advantages. Advantages of being paid: Forty three responses
80

were provided to the perceived advantages and 40 responses to perceived disadvantages. Responses in favour of fostering as a paid job fell loosely into four categories: 1. For 16 carers the perceived benets of paid work were the nancial security from receiving an income, leave entitlements and the payment of superannuation and workers compensation. 2. Thirteen carers saw a carer payment as assisting potential carers (e.g. sole parents) who needed an income when fostering. Carers saw two components to the payment a carer fee and a subsidy for the child. 3. Eight carers saw other benets such as beer screening/assessment of potential carers and increased carer skill development. Carer responsibility and professionalism would also be strengthened. A carer payment would improve respect for carers and assist with carer retention. 4. Six carers saw benets for fostered children. A carer payment would aract younger and more qualied people into foster caring. Disadvantages of being paid: Forty responses were not in favour of foster caring as a paid job. These responses also fell into four categories: 1. Seventeen carers saw a carer payment as nonbenecial for fostering. It would aract the wrong people who would only foster for the money. 2. Ten carers saw the carer payment as nonbenecial for children. Payment would have a negative impact on fostered children, their needs may not be met and inappropriate placements could be made. 3. Eight carers could not see how payments would benet carers as they would lose entitlement to government income support payments and associated benets. They would also have to pay income tax. 4. Five carers struggled with the incongruity between the public world of work and the private domain of the home. If the carers home was her workplace and the workplace was her home how could the 24 hour nature of foster caring t into a normal eight hour working day.

Fostering as paid work: Reecting on the advantages/ disadvantages the following comments from carers illustrate their thoughtful responses to the notion of fostering as paid work. In relation to potential carers who might need a salary or wage when fostering, one carer, a part-time worker with one foster child said: Its probably a very good idea, though, because there is not enough foster carers. Women can just go out and earn a lot more than they can staying at home [fostering]. If the allowance (e.g. fee/salary/wage) was enough, thought one carer, it would aract wives and mothers who needed a second income to be a foster carer rather than re-enter the paid work force: With the crisis in [recruiting] carers I feel fairly strongly that if the allowance was enough it would be aractive to people to say Look rather than going back (for the mother) and having that second income - I can get as much out of caring for this kid over and above what it is costing me to justify not going back to work. Some carers saw payment as an advantage to sole parent carers. Speaking of a friend one carer said: There are some really good foster carers out there. Dorothy shes a single mum. Shes a lot older, looking aer her granddaughter and shes got three other foster children. Geing paid for fostering would help her. She hasnt got the support of a husband or a partner or another income coming in. An experienced Indigenous carer also supported the notion of pay for fostering noting that the important issue was the motivation (i.e. wanting to care for children) that prompted women to be a foster carer: I think if other women say I am going to make a career, even unconsciously, make a career out of fostering then they need to have that nancial support. I do believe that if women want to have a superannuation fund and the benets that come with that it should be there for them. The most important question is the motivation for starting and continuing to foster.

Another carer married with own and foster children felt fostering prevented her from going out and working and contributing to the family income. She would like to see within the subsidy some element of reward for the carer: That money [subsidy] that Im geing [it] would be nice if it was a lile bit more than the expense of the child. That way I could really look at it as a job. Yes, thats my problem, I cant go out and work in the day because of the foster children. Recognition should be given by fostering agencies, said one carer, to the times when a carer must stay at home with a particular child with special needs or challenging behaviours or a sibling group, and who could not do paid work. One carer, a nursing sister in part-time employment, who thought paying carers was a good idea was keen to emphasise that this would depend on what the pay scale was. It might mean she said looking for a whole dierent set of people and that paid carers would have to keep up to date in their skills. Whether the government could pay carers enough for what they do was a concern of another carer. Superannuation: Eight carers saw the advantage of superannuation being paid for carers. As one carer said Youd have something at end of the tunnel, the end of your working life, you would know something would be there. Another agreed with superannuation being paid to carers. She would be happy with the governments contribution even if she couldnt cocontribute, saying: I believe we do deserve that. Workers compensation: Being entitled to workers compensation was seen as important by three carers. One carer, who has fostered for a number of years, spoke quite despondently about the lack of concern for carers who have been injured on the job: We have nothing, we get nothing. It should be built in, super and workers comp. I know many of the carers, theyre absolutely mentally exhausted. Theres no compensation, just tough luck. Valuing and respecting carer skills, responsibility and professionalism: Three carers thought any payment for carers should be similar to what others in the eld of care work received. Among some suggestions

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

81

was the notion that already qualied people (in caring occupations) and younger people might be aracted to fostering. Paid carers would also develop their skills and become more responsible and more professional. The need for carers being more qualied was explained uently by one carer, a qualied nurse: The kids are becoming more dicult and more complicated. A lot of them need counselling or psychiatric care or medication, theyre coming through with multiple health problems. A lot of them are prematurely born and are undernourished at birth or theyre drug-addicted. And those problems continue and create lots of health problems later down the track. And if youre not able to identify, at least have some understanding of those. I think one can get really lost [Your qualications (nursing) have been of value?] Yeah, absolutely. One non-government agency carer, fostering for 14 years, who receives substantially more ($500 a week)4 than most carers fostering for DoCS commented: You cant do it for the love of it; because you cant nancially . Youve got to have some kind of security. If I was not geing paid there is no way I would have put up with the abuse Ive put up with over the years the disrespect thats a big thing. For another carer being paid meant that carers would be given more respect, they would be seen as part of the team and be on the same level as Departmental workers. She concluded: Im just afraid that people would take on the job for the wrong reasons but at the same time I do understand that while ever you are out there as a volunteer you are not respected as much. Tax and working conditions: The loss of their pension (and other benets) and the payment of income tax if carers were paid was a concern for some carers. One carer struggled to understand how some conditions that usually accompany paid work such as recreation and sick leave and set hours of work could ever apply to foster caring. Similar issues were also a concern to two other carers. One carer, being

very practical, laughingly said: What would you do for a sickie? (laughter) Oh, sorry, just ring the oce You cant get anyone to ring back at the best of times, and the oce is closed on Thursday for half a day. So dont get sick on Thursday because you cant ring anybody to replace you. Aer [trying] for ve years I now get respite once a month to go out to dinner! How would I get a holiday? Fostering as work and love: Ten carers were equivocal about payment for carers. They could see the benets of being paid as a carer but it was not an idea that did not bring with it its own set of problems. Two carers tried to disentangle the work and love aspects of fostering: I dont like to think that the kids are a job. It is a job I suppose emotionally, its a love job, put it that way (laughter). Thats how I think of it. It is a love job. And it is, its hard work. I wouldnt want to think fostering had become a job. Perhaps people would do it simply for payment, and thatd be a bit sad. And not become a bit emotional like me. And how could you really, really care for these children if you dont become involved, if you dont become aached. Many carers were also concerned that if carers were paid it would aract inappropriate people - people who would be motivated to care for the wrong reasons. As one carer said: I think fostering would go down a lot if its a paid job. It would change it completely. There would be people in it for the money. Fostering is something you have to have in your heart. One carer, concerned at some people in the system currently doing it for the money felt if the Department wanted to be sure carers were doing the right thing by children, they should keep a beer eye on them She
1. At the time of the interviews in August 2005 NSW DoCS provided all carers, depending on the needs of the child ,with a fortnightly subsidy of $364.00 (Standard CARE Allowance, (SCA)); $525.00 (CARE+1, (CA+1)) and $700.00 (CARE+2, (CA+2)). At 22/09/05 SCA increased to $364, CA+1 to $546 and CA+2 to $721. At October 2006, carers received a further increase in the level of allowance and age-related payments were re-introduced for NSW carers.

suggested workers provide beer supervision of carers and go and see them once a week make sure that they are doing what they should be doing. She also felt that carers who were known to be foster caring for the money gave other carers a bad name.

Barber J. G., Delfabbro, P. & Cooper, L. L. (2001), The predictors of unsuccessful transitions to foster care, Journal of Psychology & Psychiatry, 42(6), 785-790. Butcher, A. (2004a), Geing Smarter in the Smart State: Strengthening fostering families into the future, Keynote Address at the CROCCS Conference, Building Stronger Families, Windmill Reception Centre, 6-8 August, Mackay. Butcher, A. (2004b), Foster Care in Australia in the 21st Century Developing Practice, 11, 42-54. British Association for Adoption and Fostering (BAAF), (2006) Are foster carers paid? hp:// www.baaf.org.uk/info/rstq/fostering.shtml (accessed August 2006). Carter J., (2002) ..towards beer foster care.. reducing the risks, Melbourne, The Childrens Foundation. Children and Family Welfare Association of Australia (CAFWAA), (2002) A Time to Invest in Australias Most Disadvantaged Children, Young People and Their Families, Policy Paper, Sydney, CAFWAA. Colton, M. and Williams, M. (eds.), (2006) Global Perspectives of Foster Family Care, Dorset, UK, Russell House Publishing. Corbillion, M. (2006) France in Colton, M. and Williams, M. (eds.), Global Perspectives of Foster Family Care, Dorset, UK, Russell House Publishing. New South Wales (NSW). Department of Community Services (DoCS), (2004) Framework for the Future of Out Of Home Care in NSW, Asheld, DoCS. Dore, M. M. and Mullin, D. (2006) Treatment family foster care: Its history and current role in the foster care continuum, Families in Societies, 87(4), 475-481. Evans S. and Tierney, L. (1995) Making foster care possible: A Study of 307 foster families in Victoria, Children Australia, 20, 4-9. Hillian, L. (2006) Reclaiming residential care: A positive choice for children and young people in care, Developing Practice, 16, 55-62. Hojer, I. (2006) Sweden in Colton, M. and Williams, M. (eds.), Global Perspectives of Foster Family Care, Dorset, UK, Russell House Publishing. Ironmonger, D. (2004) Bringing up Bobby and Bey:

IS IT TIME FOR CONSIDERATION OF A CARER PAYMENT?

It appears that in some countries practical solutions are embedded in policies for foster caring, including: the payment of a carer fee or wages; compulsory professional carer training; income tax exemptions; and a pension on retirement from fostering. These policies have been implemented to assist in the recruitment, support and retention of a workforce of trained and competent foster carers. Whether such an approach for foster carers in Australia is an appropriate solution in addressing the crisis in foster care remains to be seen. To ensure the viability of fostering, as a positive and quality option for children requiring care however, means that the payment of a carer fee (wage or salary) and the associated benets accompanying a more professional carer role does need to be debated and discussed by those involved in the foster care sector.

BIBLIOGRAPHY
Association of Childrens Welfare Agencies (ACWA), (2006) Residential Care in NSW, OOHC Development Project, ACWA&CCWT, Sydney. Australian Foster Care Association (AFCA), (2001) Preventing Child Abuse and Providing Support for Parents in the Australian Foster Care Sector, Report prepared for the Department of Family and Community Services, Canberra, AFCA. Australian Institute of Health and Welfare (AIHW), (2006), Child Protection Australia 2002-03, Child Welfare Series No. 38, AIHW Cat. No. CWS 26, Canberra, AIHW. Barbell, K. & Wright L. (1999), Family foster care in the next century, Child Welfare, LXXV111(1), Jan/Feb. 3-15.

82

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

83

The inputs and outputs of childcare time, in Folbre, N. and Biman, M. (eds.) Family Time The Social Organisation of Care, Routledge, London. James, S. and Meezan, W. (2002) Rening the evaluation of treatment foster care, Families in Society, 83(3), 233-244. Jarmon, B., Mathieson, S., Clark, L., McCulloch E. and Lazear K. (2000) Florida Foster Care Recruitment and Retention: perspectives of stakeholders on the critical factors aecting recruitment and retention of foster parents, Florida, Lawton and Rea Chiles Centre for Healthy Mothers and Babies. Kirkton, D. (2001) Love and money: payment, motivation and the fostering task, Child and Family Social Work, 6, 199-208. Kirkton, D., Beecham, J. and Ogilvie, K. (2003) Remuneration and Performance in Foster Care, Final Report, Canterbury, University of Kent. McDonald, P. (2001), Family support policy in Australia: the need for a paradigm shi, People and Place 9(2), 15-20. McHugh, M. (2002) The Costs of Caring: A Study of Appropriate Foster Care Payments for Stable and Adequate OOHC in Australia, Report prepared for CFWAA, AFCA, and ACWA, Sydney. McHugh M., McNab, J, Smyth, C., Chalmers, J., Siminski, P. and Saunders, P. (2004) The Availability of Foster Carers: Main Report, Asheld, Department of Community Services. Moller, D. (2003) Western Australia Foster Carer Recruitment Service: Summary of Results July 2002 to June 2003, unpublished. New South Wales, Standing Commiee on Social Issues (SCSI), Legislative Council, (2002) Care and Support, Final Report on Child Protection Services, Parliamentary Paper No. 408, Sydney. Oldeld, N. (1997) The Adequacy of Foster Care Allowances, Ashgate, England. PeakCare Queensland, (2002) Towards Sustainable Services for Children, Young People and their Families: The real costs of providing child protection services in Queensland, Brisbane, PeakCare Queensland Inc, November.

Rhodes, K. W., J. G. Orme, and C. Buehler (2001) A comparison of family foster parents who quit, consider quiing, and plan to continue fostering, Social Service Review, 75, 84-193. Rhodes K., Orme, J.G., Cox, M.E. and Buehler, C. (2003) Foster family resources and psychosocial functioning and retention, Social Work Research, 27(3), 135-151. Sellick, C. (1999) Can child and family social work research really assist practice? Children Australia, 24(4), 93-96. Semple D. & Associates (DS&A), (2002) Review of Alternative Care in South Australia, DS&A, March, Adelaide. Sinclair, I., Wilson, K., and Gibbs, I. (2004) Foster Placements: Why They Succeed and Why They Fail, London, Jessica Kingsley Publishers. Smith, B. (1988) Something you do for love: The question of money and foster care, Barnardos Discussion Paper No. 5, Sydney, Barnardos. Smith, B. and Smith, T. (1990) Women as foster mothers, AFFILIA, 5(1), 66-80. Sultmann, C. and Testro P. (2001), Directions in OOHC: Challenges and Opportunities, Brisbane, Peak Care Queensland Inc, February. Testa, M. and Rolock, N. (1999) Professional Foster Care: a future worth pursuing Child Welfare LXXV111(1), Jan/Feb, 108-123. Thompson, M. (1999) Women and Retirement Incomes in Australia: Social Rights, Industrial Rights and Property Rights, SPRC Discussion Paper No 98, Sydney, University of New South Wales. Thorpe, R. (2004) You have to be crackers: worker and carer experiences in the foster care system, presentation at the National Foster Care Conference, Walking Together: People, Policy and Practice, October, Canberra. Thorpe, R. (2006) James Cook University Mackay/ Whitsunday Foster Care and Foster Carers Research Study, (personal communiqu). Triseliotis J., Borland M. and Hill, M. (2000) Delivering Foster Care, London, BAAF.

Van Sloten, B. (2006) Comparison United Kingdom, the Netherlands and Poland Fostering Services, personal communiqu. Victoria. Department of Human Services (DHS), (2003) Public Parenting: A review of home-based care in Victoria, Melbourne, DHS. Wehrmann, K., Unrau, Y. and Martin, J. (2006) United States, in Colton, M. and Williams, M. (eds.), Global Perspectives of Foster Family Care, Dorset, UK, Russell House Publishing, Wise, S. (1999) Childrens coping and thriving, not just in care Children Australia, 24(4), 18-28.

84

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Research article 7

85

A REFELCTION
and physical damage that can result, makes child abuse and neglect the greatest barrier and threat to Australias social and economic wellbeing. The impact of child abuse and neglect on Australian society includes increased levels of violence and crime, educational failure and employment, as well as the increased costs for services and systems for mental and physical health needs. These consequences can be life lasting and it has been found that the perpetration of violence and abuse can also be passed on to future generations.5 The economic costs of child abuse and neglect were estimated to be $5 billion in 20036, and a further $769 million in 2004 was determined to be the additional cost of family violence on children.7 In total this estimated cost of child abuse and neglect is more than Australias annual income from meat exports, before factoring in the increases in the scale of child abuse and neglect since 2003.8 These costs are conservative since we know most abuse and neglect is hidden and not reected in the statistics, and because every statistic about child abuse and neglect has worsened reports, substantiations, care and protection orders, and the number of children living in out-of-home care9 since these costs were calculated. It is a sad irony that while some Australians strive for nancial success to become millionaires there are now hundreds of individual children and youth whose protection in out of home care costs more than a million dollars every year. The costs of child abuse and neglect alone do not justify the stated view that current trends and levels of child abuse and neglect are unsustainable. To demonstrate this a broader economic view must be taken. Climate change requires us to look into the future of the Australian economy. My work with Greenpeace on the economics of climate change highlighted a massive ecological challenge for Australians, one arguably we are already grappling with (low rainfall, coral bleaching, extreme weather events and our rst climate change refugees in the Pacic). The impacts of climate change and the transition of our economy to be sustainable will place nancial strains on everything, including public spending. Australias economy currently has a substantial dependence on fossil fuels, carbon consumption and emission. The economic transition to sustainable energy and low carbon consumption will require massive investment (nancial and human). Yet today only 1/3rd of 1 percent of total spending on child abuse today is invested into prevention compared with 992/3rds spent on treatment. State and territory government funding for child protection has increased in all jurisdictions over the last ve years, with recurrent expenditure totalling $1.2 billion in 200405, the Australian Government spent a mere 1/300th of this amount, $4.2 million, on child abuse prevention in the same period.10 11 The economic lessons from the above are clear and urgent: substantially greater investment is required on child abuse prevention; the need for spending on treatment services will continue to increase until this prevention investment is made and takes eect; and, imminent economic pressures from climate change bring urgency to the need to reduce the economic costs of child abuse and neglect. To eectively prevent child abuse and neglect, before it happens, we must now address the dinosaur in the room. As the opening paragraph demonstrated, when we ask Australians to prevent child abuse and neglect the negative prevention frame is lost and they in fact think of child abuse and neglect. Since the public view of child abuse and neglect is dominated by the cases portrayed in the media of graphic and extreme assault, harm and neglect, their response to any call for prevention is to call the authorities and make greater demands of struggling formal systems. Yet to be economically sustainable what is needed is greater community responsibility, not greater community demands from the child protection sector.
Tomison, 1996 Keatsdale Pty Ltd and Kids First Foundation, 2003 7 Access Economics Pty Ltd, 2004 8 Australian Bureau of Statistics, 2005 9 Australian Institute of Health and Welfare [AIHW], 2001, 2002, 2003, 2004, 2005, 2006 10 Australian Government Productivity Commission, 2006 11 Australian Government Department of Family and Community Services, 2005
5 6

Child Protection Dinosaurs

Adam F Blakester
Is it possible for someone to ask you Dont think of a dinosaur1 and not actually think of, or picture, a dinosaur? Perhaps you see a brontosaurus, a T-Rex or a pterodactyl. When the negative frame (dont) is used the positive (dinosaur) frame still dominates and is brought to mind. What then does the Australian public think of when we ask them to prevent child abuse and neglect? This reection piece explores the lessons this dinosaur holds for our work in child protection and more specically the prevention of child abuse and neglect; building on an earlier article published in the National Child Protection Clearinghouse journal.2 NAPCANs Approach3 for the primary prevention of child abuse and neglect that is, prevention of child abuse and neglect before it happens incorporates these lessons and identies ways the child protection and broader childrens sector can work together to increase community responsibility for the wellbeing and safety of all Australian children. Current trends and levels of child abuse and neglect are economically unsustainable. This requires the child protection sector to reect deeply on current work approaches and identify new ways forward that protect children and are economically sustainable. My career began in commerce and law, working with one of the Big 4 global chartered accounting rms. This background has led me to delve into the economics of childrens wellbeing and maltreatment. Aer 15 years in nance, law and business my career moved into social change arenas, most recently with Greenpeace. My studies and work in social change and social marketing, community psychology and development have led me to delve into the dinosaurs in our midst as well. Child abuse and neglect is Australias most serious social and economic problem, bar none. Today, a child protection report is made every two minutes a rate that has doubled in only the last four years. A child is substantiated as having, or being likely to have, suered child abuse or neglect every 11 minutes more than 34,000 individual children in 200405 alone.4 Further, the well known long term psychological, emotional
1 The concept of Dont think of a dinosaur is an adaptation of George Lakos work in the book Dont think of an elephant. 2 National Child Protection Clearinghouse, Child Abuse Prevention Newsleer, Vol.13 no.1 Summer 2005 3 NAPCANs Approach, Five Year Plan, 2005-2010 4 AIHW, 2006

Adam F Blakester National Executive Ofcer NAPCAN (National Association for the Prevention of Dinosaurs) Phone: +61 2 9211 0224 / +61 419 808 900 Fax: +61 2 9211 5676 Email: adam@napcan.org.au 86

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

A reection

87

NAPCAN (the National Association for Prevention of Child Abuse and Neglect) believes that this critically important prevention message is not working. NAPCAN believes that this message in fact conjures up thoughts, feelings and images in the public frame of mind that are barriers to eective action and community responsibility for childrens wellbeing and safety. The Dont just stand there public education campaign highlighted for NAPCAN these signicant problems with our public messages. The campaign ran for two years from September 2004 until August 2006 and challenged Australians to not just stand there and do something to help prevent child abuse and neglect from happening.12 However, the overwhelming public response to this call to action was leers, emails and phone calls reporting cases of child abuse or neglect or failures of services and the child protection system. While this response did demonstrate a willingness in the community to not just stand there, the campaign largely generated more demand on professional intervention (police, child protection) a long way from primary prevention and early intervention. There have been similar ndings from USA research about the dominant frames of thought and response in the public mind, specically: Child abuse is one of the best covered news topics, mostly graphic, sensationalist, and criminal (sexual and physical assault, fatal neglect) because it ts within a well established news beat (crime). It is an easy story to tell. The dominant news frame is a horrible, criminal atrocity some monstrous parent has commied, and the horrible suering of the child[ren] in question. This meaning of child abuse and neglect clearly drives Australians to think that only professional intervention can make a dierence or is even safe. The eects of this media focus is to reinforce the notion of widespread parental decits and the conclusion that the problem lies internal to the person (rather than community strengths) and so in fact we are weakening the village by reinforcing the belief that the only solution is to

call the authorities. NAPCAN has created Child Friendly Australia for our public work to address these issues. Child Friendly Australia will undertake a long term social change strategy to inspire every Australian to make a positive dierence to the wellbeing and safety of children and youth. It reects NAPCANs view that we need to radically shi our messages into a positive, solution focused frame addressing protective factors. The story of Windale, NSW, provides important evidence for this way forward. Windale is arguably Australias greatest child protection success socially and economically. The Windale community in the NSW Lake Macquarie region demonstrated that reducing and preventing child abuse and neglect is possible and achievable. Originally established as a suburb by the NSW Department of Housing in 1999, Jesuit Social Services rated Windale as the most socially disadvantaged community in NSW (where community was dened by post code area). A comprehensive three year community renewal process improved the situation with Windale moving from the worst 1% in terms of child protection notications in NSW in 1999 to the best 25% in 2003. It is through child abuse prevention that we create potential for the greatest social and economic returns on our investment. A Michigan study found that investments into prevention were economically justied and cost eective when compared to the costs of treatment even if only modest reductions in abuse events were achieved.13 The US Perry Preschool study found an economic return to society of more than US$17 for every tax dollar invested in an early care and education program thats equal to 13% compound interest every year for 40 years and signicant benets in employment, earnings, home ownership and nancial wealth (Schweinhart, 2004). NAPCANs Approach presents a shi to the community-wide and community responsibility focus such as that begun in Windale in 1999, towards
12 13

an inspiring and ambitious solution oriented vision that every Australian community is child friendly and beyond the dinosaur of focusing on child abuse and neglect that we dont want. To best understand this shi it is useful to unpack NAPCANs vision of Every Australian Community is Child Friendly and explore its depth of meaning: every reects a universal approach, as primary prevention strategies are. NAPCAN is appealing to all Australians, not only parents and professionals, of all cultures, languages, faiths and ages to take responsibility; community signals a community-wide and community-based approach (such as Windale) and appealing to the wider community to play a supportive and complimentary role with services; is this is an end point, a goal, an outcome as visions are meant to be. Is signies that communities are child friendly as opposed to becoming child friendly we obviously have some work to do; child from pre-conception to 18 years of age, and is shorthand for children and youth; child friendly is short hand for childrens wellbeing and safety. A Child Friendly Community provides children with opportunities for optimal growth and development: socially, emotionally, culturally and spiritually. It embodies a life for children, free from harmful or abusive behaviours, systems and services. Families, parents and carers are supported within their community and readily access help when experiencing diculties. Children are valued, respected and actively included in the community. The United Nations Convention of the Rights of the Child is used as the underlying wellbeing framework for what is child friendly. The four outcomes we seek for children are that they are able to: Play a Part being included in decisions, freedom to join with others, freedom to express themselves and freedom to receive information; Reach their Potential the right to the things neededfor optimum development, including

education, family, culture and identity; Live Well the right to survival includes all the basic needs of food, clothing, shelter, health, and an appropriate standard of living; and, Be Free from Harm children and youth are protected fro m abuse, neglect, economic exploitation, torture, abduction, and prostitution. NAPCAN believes that in order to reduce and eliminate child abuse and neglect we must work to create sustainable child friendly communities that provide and support childrens wellbeing. Child friendly communities and childrens wellbeing are the protective factors which reduce the risk factors associated with child abuse and neglect and build resilience against any harm that does occur. Through Child Friendly Australia NAPCAN has just launched its new public education campaign, Children See Children Do. The advertisement has won a global silver medal award for best ad of the month. Cyber, cinema, outdoor, print and radio media streams will come online over the next few months. The advertisement can be viewed online via the Child Friendly Australia website at hp://www.childfriendly.org.au/tvc.htm. The value of NAPCANs Approach and this shi to build child friendly communities rather than prevent dinosaurs is demonstrated by the extraordinary outcomes achieved in the last two years: ve fold increase in media coverage with increased focus on messages and stories about child friendly communities and community responsibility; 1,000% increase in web site usage to 8-10,000 unique visitors per month growing membership of the Child Friendly Community Action Network which provides leadership and oversight of community responsibility plans addressing the wellbeing and safety of all children; exponential growth in public participation in National Child Protection Week (over 750,000 people in 2006 compared with 45,000 in 2003) with signicantly more involvement from the wider community (beyond child protection);
89

hp://www.childfriendly.org.au/tvc.htm Caldwell, 1992

88

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

A reection

 identication and recognition of hundreds of Child Friendly Initiatives across Australia which in turn form the basis of media stories, advocacy and toolkits for use by other communities; dozens of parents and adults making positive changes in discipline and relationships with children theirs and others from having watched Children See Children Do; innovative action research projects asking the experts, children and youth themselves, on what it is that makes their communities child friendly, and helps them grow up well, free from harm; australian Senate discussions about preventing child abuse and neglect during and since National Child Protection Week 06; development of a wide range of new NAPCAN child-centred programs including Child Friendly Awards, kidsCAN (Kids Community Action Network) and Child Friendly microgrants. While Child Friendly Australia focuses on the public at large and the role that all adult Australians can play in creating child friendly communities, the new NAPCAN will expand its work providing training and tools for workers that enable them to support and create protective factors with children, families and communities as the way to reduce the incidence and risk of child abuse and neglect. A National Associates Network will soon be launched as the worlds rst national network focused on the protective factors for the wellbeing and safety of all children and youth. This primary prevention focus is complimentary to the Australian College for Child and Family Protection Practitioners focus on protection. Associates will be drawn from a broad group of workers ranging from volunteer sports coaches and bus drivers through to teachers, paediatricians and social workers. This analysis highlights that the meaning of the phrase prevention of child abuse and neglect has been corrupted and lost, at least for now. Prevention in this phrase has come to mean prevent child abuse or neglect from happening again, the very opposite of the truism that prevention is beer than the cure in this sense the cure and prevention have come to mean one and the same thing.

As dicult as it is to accept, prevent child abuse and neglect is a dinosaur. This phrase conjures up in the public mind a need for professional intervention rather than community responsibility. It also brings focus to the problem (child abuse and neglect) rather than the solution (prevention). The prevention message is lost in the numerous strongly held and familiar stories people have learned over time about child abuse the use the prevention frame does not advance prevention in policy. We must now shi our focus to creating a frame in the publics mind which moves them to not just stand there, towards taking responsibility alongside the thousands of practitioners and professionals working in Australia to turn around and reduce our most serious social problem of all child abuse and neglect. Later this year NAPCAN will release the ndings from our 2006 Ask Kids research. Children and youth have described child friendly communities with a very inclusive vision for all people within them. Relationships are the most important quality observed in young peoples responses about what makes a community child friendly. They talk of respect, multiculturalism and friendly spaces for relationships: relationships with family, friends, teachers, the wider community and themselves. Resilience research conrms that even one strong and healthy relationship can make a powerful dierence to children living with adversity. Positive outcomes for children and young people in areas such as education, health, safety, and employment may well only be possible if we deliver sustained outcomes in the form of meaningful relationships for children and youth. A social worker I know in Sydney had worked with a particular family for over a decade. During this time, the son of the family had become a teenager. One day, the social worker was feeling very low, struggling to nd the strength and courage to face another session with the young man, knowing what he had survived over more than 10 years. The social worker asked: Can you tell me how it is that you have survived through everything? What was it that kept you going? The young man replied:

Every day, when I used to get on the bus to go to school, the bus driver used to ask me Hows my lile ray of sunshine today? I knew then that I was someone; that I maered. At the same time this bus driver was delivered a service of taking children from home to school and back again, the driver established a relationship (though probably never knowing the dierence it made to the boy). The bus driver showed the boy he was valued and valuable. This was the real outcome.

90

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

A reection

91

BOOK REVIEWS

Grapple: Coming to Grips with Mental Health: An Interactive Journey

Royal Flying Doctor Service of Australia, Queensland Section, RFDS Cairns Base, PO Box 187H, Edge Hill, Qld 4870, Phone (07) 40531952, Version 1, CDROM with user Manual and Operating Instructions, 2003, $37.40

Orphans of the living: Growing up in care in twentieth century Australia

Joanna Penglase (2005) Curtin University Books, Fremantle ISBN 1 92073 181 4 - $29.95 (paperback)

This interactive CDROM was recommended by colleagues within the Cairns Department of Child Safety Service Centre as being a useful resource to explore mental illness with children and young people. They also described that they had used the tool over a number of sessions with children and their foster carers as a strategy to explain about the childs parents experience of mental illness. Grapple focuses on dening the meaning of core terms and concepts used in the mental health service system in Australia. Grapple is based around a simple hiking camping experience with a naive cartoon context. Users are given a variety of landscapes to explore including the Wellbeing Oasis, Problem Rainforest, Disorders Mountains. The Wellbeing Oasis obviously focuses on developing an understanding of wellbeing and provides tips of maintaining good mental health. The Problem Rainforest describes some of the most common mental health problems and how to identify them as well as simple strategies to overcome them. This section is the most thorough and at the completion of the interactive games, puzzles and quizzes the user should have a solid understanding of core mental health terms. The last section of the Disorders Mountains describes some of the more common psychiatric disorders and basic forms of assistance and treatment. The play format is a lile disjointed but the overall quality and usefulness of the tool cannot be denied.
92

My lap top had diculty with some of the dynamic graphics and sound at the end of each environment where a view such as a waterfall with the sound of falling water and birds singing plays as a reward for successfully completing the environment. Successful completion of each environment requires the user to add words to their dictionary and collect items for their Grapple Pack. There is also a feature that allows the user to document notes or create a virtual diary or journal of discussions and ideas which may arise from the puzzles or activities. There is also the potential to print the information provided at each stop so that a hard copy of the resource can be created. I couldnt get through the CDROM in one session, nding the process a lile simplistic and repetitive. However if I was using Grapple with a client over a number of sessions, my aention would have been held more easily. Improvements could be made in having more printable resources such as colouring in pages and some group activities, but generally I recommend Grapple as a valuable resource for those working with children. I particularly warmed to the Australian accents and Australian animals, birds and concepts. Michael Bishop Relate Human Services Pty Ltd. Mackay, Queensland.

In the twenty years following World War II, over 500 000 children were institutionalised in Australia. Separated from family due to relationship breakdown, poverty, domestic violence, parental death or deemed incapacity, children were sent to live in Homes run by the state or by charitable or religious organisations that were charged with providing children with discipline and training. Although there has been some work focused on how these institutions were developed and how their programs were implemented, lile is known about how children themselves experienced their engagement with the substitute care system and what impacts living within such systems had on their immediate and long-term lives. Orphans of the Living by Joanna Penglase aempts to redress this by sharing stories from adults who had been children of the state and describes her academic but very personal search for meaning and understanding. Orphans of the Living takes its readers on a moving but harrowing journey. Within its pages, one is confronted by accounts of physical, emotional, psychological and sexual abuse perpetrated against children in the care of the state by adults charged to protect and support them and of the states inability or unwillingness to intervene. In the book, Penglase discusses how the policy of child separation developed and became popular. She describes the day-to-day lives of children in care: the structured and controlling routines, the cold and punitive

discipline, the lack of care, nurturance and warmth inherent in what she sees as a poorly provided and regulated system. She challenges, as many such state wards did, how children could be removed from their families for their own good and placed in equally or more brutal environments. Drawing from her own experience and that of other adults engaged in the system from the 1940s to the 1970s, Penglase allows their voices to be powerfully heard. Within the text, Penglase makes the important point that much of the tragedy experienced and the violence inicted upon children was underpinned and justied by the pervasive view that orphaned children were deviant and needed to be controlled and re-developed, and that their needs, views and aspirations were of secondary concern. Penglase presents through her portrayal of institutional life, however, the view that unless children are valued, encouraged and allowed to take some control over their lives long lasting and oen-devastating consequences follow. Throughout the text, Penglase introduces caveats of discussion from a variety of disciplines in an aempt to broaden the books focus from being an historical narrative to being a critical analysis of the broader system. Though they challenge the reader to draw connections with other narratives (Penglase compares childrens experiences with those of the Stolen Generations, concentration camps and Foucaults prisons), sometimes their inclusion
93

Communities, Families and Children Australia, Volume 2, Number 1, April 2006

Book reviews

distracts and diminishes the poignancy of childrens actual accounts. Conversely, Penglases decision to not include the views and opinions of service providers nor archival records leaves the critical question why did this ever happen? substantially unanswered. In excluding these voices, readers also remain unsympathetic to the challenges confronting those who worked in the systems or allow for those who were caring, responsive and eective to be suciently acknowledged. Penglase justies this exclusion by making the point that while governments, media and systems focus primarily on the positive outcomes children who lived in care, those who suered in institutions are unable to elicit sucient understanding and consolation. Though this is the case, it must be noted that not all carers and not all service providers abused children during this period and that further work is needed to draw historical accounts and personal narratives together so that a more global understanding can be realised and eective change enacted. What also appears to be missing from Penglases discussion is an acknowledgement of the obvious strength and resilience of children who survived within these dicult environments. Though their stories are lled with an overwhelming sense of sadness, anger and loss, the adult care leavers (including Penglase herself) and their families survived their ordeals and developed a determination to protect future children from similar harm. Without sugar coating their experiences, further discussion about the care-leavers strengths and achievements would enable the reader to understand them not as passive victims but as active survivors who needed understanding and assistance rather than pity or saving. However, Orphans of the Living is a well wrien, courageous and insightful read. Penglase shines light on the lives of children who had previously been hidden from view and allows us to confront a history previously unexplored. It cannot be said that the book is an easy read, as one feels a range of emotions: anger when confronted by stories of abuse; sadness as one empathises with the small children

who suered such grief and loss; shame when one realises that injustice saturated the lives of our most vulnerable with the complicity of the community. Orphans of the Living should be compulsory reading for those working with vulnerable families and those shaping policies that aect their lives. Tim Moore Institute of Child Protection Studies Australian Catholic University

94

Communities, Families and Children Australia, Volume 2, Number 1, April 2006